The Lympha Press Podcast

November’s Lymphedema Patient Roundtable brought together expert guidance, inspiring patient experiences, and timely reminders about the importance of self-care, especially during the busy holiday season.Moderator Brenda Viola welcomed lymphedema specialists Rachel Alonzo of Mayo Clinic and Karen Ashforth, along with patient advocates Angela Jones and Tora Rocha. In recognition of Veterans Month, special guests included retired Marine Corps Colonel Maria Long, Lympha Press representative Coco Hines, and veteran and lymphedema patient Kristi Madore.Rachel Alonzo explained how modified decongestive therapy offers a more flexible approach to traditional Complete Decongestive Therapy (CDT). Rather than requiring intensive daily appointments, treatment can be adapted to patients’ schedules, finances, physical abilities, and personal goals. Karen Ashforth clarified that manual lymphatic drainage is just one component of CDT, alongside compression, exercise, and skin care.Veteran Kristi Madore shared how using her Lympha Press pneumatic compression device has significantly improved swelling, comfort, and quality of life, even as she works toward greater consistency with treatment. Maria Long explained that eligible veterans can receive Lympha Press equipment through their VA providers, with costs covered by the VA. The conversation highlighted the importance of helping veterans access effective, convenient care.The panel discussed the benefits of pneumatic compression, including customizable treatment options and garments designed for ease of use. Experts also emphasized the importance of recognizing possible infections and seeking prompt medical attention rather than dismissing concerning symptoms.From Thanksgiving menus to family gatherings, panelists encouraged patients to listen to their bodies, make food choices that work for their individual needs, and prioritize rest and treatment. Whether following a Mediterranean-style diet, maintaining an exercise routine, or taking time to elevate their legs, patients were reminded that self-care is not selfish.The evening closed with heartfelt expressions of gratitude for veterans, caregivers, clinicians, family, and the supportive lymphedema community.Rachel Alonzo offered a particularly empowering reminder: Lymphedema management is not a pass-or-fail proposition. Patients have more power than they realize, and it’s okay to adjust their approach along the way.The overarching message? “All or something.” Progress doesn't require perfection. Every positive step matters, and no one has to navigate lymphedema alone.

Could GLP-1 medications such as semaglutide do more than support weight loss? Emerging research suggests they may also have a direct effect on how lymphatic vessels function.

Dr. Jorge Castorena, recipient of Tulane University's 2025 Rising Star Award, joined Dr. Karen Herbst to discuss his groundbreaking research, published in Microcirculation, and what it could mean for the future of lymphedema treatment and prevention.

• A promising discovery: Laboratory studies demonstrated that semaglutide improved the pumping capacity of lymphatic vessels, helping them move more fluid and overcome greater pressure.

• Understanding the mechanism: Researchers identified GLP-1 receptors on lymphatic endothelial cells. Activating these receptors stimulates nitric oxide release, allowing vessels to dilate while maintaining effective contractions.

• Beyond weight loss: These findings suggest GLP-1 medications may improve lymphatic function directly, rather than solely through weight reduction or reduced inflammation.

• Important unanswered questions: Could similar benefits occur with tirzepatide or other GLP-1 medications? Could lower doses improve lymphatic function without significant weight loss? Might these medications eventually help prevent secondary lymphedema following cancer treatment?

• What's next: With NIH support, Dr. Castorena's team is expanding its research to human lymphatic tissues, including samples from bariatric surgery patients.

While early findings are encouraging, more research, particularly human clinical trials, is needed to determine whether GLP-1 medications can safely and effectively treat or prevent lymphedema. Their potential applications for lipedema also warrant further investigation.

Important Medical Disclaimer: This Research Roundtable is provided for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. The research discussed is preliminary and should not be interpreted as proof of clinical effectiveness. Patients should consult their qualified healthcare providers before starting, stopping, or changing any medication or treatment.

Learn more: www.lymphapress.com

Halloween Fun, Global Advocacy & Practical Tips for Living with Lipedema

The October Lipedema Patient Roundtable combined Halloween costumes, laughter, and meaningful conversation as moderator Brenda Viola welcomed special guest Susan O’Hara, President of the American Lipedema Association.

Susan shared highlights from the inaugural Lipedema conferences in Ireland and Canada, where hundreds of patients, clinicians, and advocates gathered to advance awareness, education, and research. A major discussion centered on Germany’s groundbreaking LipLeg study, which compared surgical and conservative treatments, finding significant pain reduction among many surgical patients while also documenting potential complications. The findings could help strengthen the case for insurance coverage and improved treatment access.

Panelists also explored practical approaches to daily lipedema management, including pneumatic compression, manual lymphatic drainage, aquatic exercise, vibration plates, and individualized self-care routines. Linda Anne Kahn emphasized the importance of early diagnosis, particularly among younger patients, and discussed emerging conversations about lipedema terminology and metabolic health.

In a moving personal update, panelist Siouxie Boshoff shared her struggles with a complex vestibular condition and the importance of connection during difficult health challenges. Throughout the discussion, panelists encouraged patients to listen to their bodies, establish manageable routines, and celebrate small steps forward.

The evening reinforced a powerful message: Lipedema may be challenging, but community, advocacy, humor, and hope make the journey easier. As the panel reminded viewers, self-care doesn't have to mean doing everything. Sometimes, doing something is enough.

Breast Cancer Awareness Month: Advances, Advocacy & Hope

In recognition of Breast Cancer Awareness Month, moderator Brenda Viola welcomed special guest Rochelle Brannon, MPT, OnCS, CLT-LANA, alongside Karen Ashforth and patient advocate Catherine Rosenberg, for an encouraging conversation about breast cancer-related lymphedema, advances in treatment, and the power of patient advocacy.

We've Come a Long Way! The panel reflected on remarkable progress in breast cancer treatment and lymphedema care over the past two decades. More targeted cancer therapies, improved diagnostic tools, earlier referrals to rehabilitation specialists, and emerging surgical approaches offer greater hope for patients. Rochelle emphasized that today's clinicians have more resources than ever to help patients manage their condition and improve quality of life.

Your Voice Matters. Patients often arrive at appointments armed with research after years of searching for answers. Rather than dismissing their questions, Rochelle and Karen emphasized the importance of listening, validating experiences, and developing individualized treatment plans. Catherine, who has lived with lymphedema for 35 years, reminded viewers that clinical expertise and lived experience must work together. You know your body better than anyone.

Compression and Medicare Coverage. A lively discussion addressed the importance of properly fitted compression garments and expanded Medicare coverage. Custom garments may be medically necessary when standard sizes cannot adequately accommodate a patient's limb shape or tissue changes. The panel encouraged patients to work with certified lymphedema therapists who can assess their needs, document medical necessity, and help navigate coverage requirements.

Know When to Seek Help. Audience questions highlighted the importance of recognizing possible infections and seeking prompt medical attention. The panel cautioned against using pneumatic compression or manual lymphatic drainage during an active infection without appropriate medical guidance. Persistent symptoms deserve further evaluation, and sometimes a second opinion can make all the difference.

Don't Give Up! Perhaps the evening's most powerful message was one of persistence and hope. Finding the right provider may take time, but Rochelle reminded viewers that sometimes all it takes is one knowledgeable, compassionate clinician who truly listens to open the door to better care.

Catherine encouraged patients to keep asking questions, researching options, and thinking outside the box when answers aren't forthcoming. No two lymphedema journeys are exactly alike.

As the Roundtable concluded, the panel celebrated the resilience of breast cancer survivors and everyone living with lymphedema.

Keep advocating. Keep learning. Keep moving forward. There is help available, advances are happening, and you are never alone on this journey.

Fascia, Self-Advocacy & Finding What Helps Your BodyThe September Lipedema Patient Roundtable went “back to school” with new ideas, practical patient wisdom, and encouragement—including a fascinating discussion about fascia health with special guest Kelly Maynard of Wildheart Wellness.Kelly, who lives with Lipedema and Ehlers-Danlos syndrome (EDS), introduced the panel to Block Therapy, a fascia-focused practice using a specially designed wooden block, sustained pressure, and intentional breathing. After experiencing the method herself, Kelly became certified and now teaches others.Kelly described fascia as the body’s “scaffolding” and shared her personal experience of improvements in pain, mobility, alignment, and joint stability. She emphasized starting gently—suggesting newcomers can even begin with a rolled towel rather than immediately purchasing equipment.An equally important part of the practice is slow, focused breathing and relaxation. For people living with chronic pain who may spend much of their time physically or emotionally on alert, intentionally creating moments of calm has become an important part of Kelly’s wellness journey.The conversation expanded to hypermobility, joint instability, posture and body mechanics, with panelists emphasizing the importance of finding physical therapists and healthcare providers who understand Lipedema and lymphedema.The group also shared practical tips for blood pressure checks, which can be painful for people with Lipedema. Several prefer a properly sized cuff, manual readings, and—in consultation with healthcare providers—using the forearm when appropriate. The larger lesson: communicate what hurts and advocate for accommodations that work for your body.That theme of self-advocacy continued as Angelique Charles, the Lippy Butterfly, shared lessons from a recent hospitalization and rehabilitation following a severe asthma attack. She was encouraged by increased awareness of Lipedema, lipolymphedema and EDS among healthcare professionals—and by the results of clearly advocating for the care she needed.As the panel reflected on what they’ve learned, several lessons emerged: consistency matters, listening to your body matters, and it’s okay to stop thinking about Lipedema 24/7. Do your maintenance, wear your compression, care for yourself—and then go live your life.Kelly closed with a beautiful reminder from her own life. Each morning, she takes her coffee outside and watches hundreds of hummingbirds near her Texas home. Those quiet moments remind her to notice and appreciate what is good even when life is hard.Every day is a gift. Find your “hummingbirds and coffee” moment—and take it.Learn more about Kelly Maynard and Wildheart Wellness at wildheart.health.

Research Roundtable: Lymphatics in Spaceflight

Featuring Drs. M. Mark Melin and Caroline Fife, moderated by Lympha Press Chief Medical Officer Dr. Karen Herbst

What can spaceflight teach us about the lymphatic system here on Earth? In this fascinating Research Roundtable, Drs. M. Mark Melin and Caroline Fife join Dr. Karen Herbst to explore how gravity—or the absence of it—affects fluid movement throughout the body and what those changes may reveal about lymphatic function, brain health, edema, and disease.

In microgravity, the body undergoes dramatic fluid shifts. Without gravity pulling fluid toward the lower extremities, fluid moves toward the upper body, contributing to the facial puffiness commonly seen in astronauts as well as changes affecting the eyes and brain. The discussion examines Spaceflight Associated Neuro-Ocular Syndrome (SANS) and considers how lymphatic drainage may contribute to the retinal, cerebral and other changes observed during and after spaceflight. The panel also shares the intriguing experience of Inspiration4 astronaut and childhood cancer survivor Hayley Arceneaux, who reported that chronic discomfort in her surgically treated leg disappeared while she was in space—raising provocative questions about microgravity, lymphatic congestion and pain.

The conversation also highlights a major shift in our understanding of the relationship between the lymphatic system and the brain. Long-held theories about how cerebrospinal fluid (CSF) is cleared have evolved as research has demonstrated an important lymphatic pathway for CSF drainage. That connection opens new avenues for considering how impaired lymphatic flow may relate not only to changes seen in astronauts, but also to conditions on Earth, including sleep apnea, head and neck lymphedema, edema and potentially cognitive decline.

Throughout the discussion, Drs. Melin, Fife and Herbst bring the science back down to Earth, exploring the importance of gravity, body position, movement and sleep in normal fluid management. From astronauts in microgravity to patients sleeping upright in chairs, the Roundtable offers a compelling reminder that the lymphatic system does not operate in isolation—it responds continually to our environment, movement and position. Studying what happens when gravity disappears may ultimately help us better understand how to support lymphatic health when our feet are firmly planted on the ground.

September’s Research Roundtable explored ModifiedDecongestive Therapy (MDT), an approach being studied by Mayo Clinic occupational therapist and lymphedema specialist Rachel Alonzo.

Complete Decongestive Therapy (CDT) remains the gold standard for lymphedema treatment, but access can be challenging due to limited insurance coverage, shortages of trained therapists, geographic barriers and the intensity of traditional treatment.

Alonzo’s research asks: Can we preserve theessential elements of CDT while making treatment more accessible and patient-directed?

MDT emphasizes self-management. Patients learn lymphatic exercises and self-manual lymphatic drainage (MLD), with compression introduced as appropriate. Pneumatic compression may also be incorporated. Instead of intensive daily appointments, patients return periodically for reassessment, hands-on treatment and adjustments to their home program.

Early results are encouraging. Patients in Alonzo’sstudy have demonstrated at least a 10% reduction in limb volume over approximately three to five months, along with improvements in quality of life. While MDT generally takes longer to achieve results than traditional CDT, it may require fewer clinic visits and make treatment more feasible for patients who have difficulty accessing specialized care.

Three components remain central: lymphaticdrainage, compression and movement/exercise.

Alonzo emphasized that MDT is not intended toreplace CDT. Instead, it offers another option—one built around partnership, flexibility and helping patients successfully manage their condition at home.

The takeaway? Effective lymphedema care isn’t simply about prescribing the ideal treatment plan. It’s about creating a plan patients can realistically sustain—and empowering them to become active participants in their own care.

Special thanks to Karen Ashforth, MS, OTR, CLT-LANA, who moderated the discussion.

To learn more about Lympha Press pneumatic compression therapy, visit www.lymphapress.com.

The September Lymphedema Patient Roundtable was a “back-to-school” session, with longtime patients and advocates sharing the most important lessons they’ve learned about living with and managing lymphedema.Moderator Brenda Viola was joined by Karen Ashforth, MS, OTR, CLT-LANA, Catherine Rosenberg, Angela Jones and Tora Rocha for a candid conversation about building the right care team, becoming your own advocate, navigating misinformation and learning to listen to your body.A major theme was the importance of a multidisciplinary approach. Catherine’s complex journey ultimately involved approximately 19 providers, along with mental health support and a trusted “second set of ears” at appointments. But the most important member of your care team is you, the patient. You know your body and your experience. Tora echoed the importance of finding knowledgeable clinicians, staying curious and building a supportive community.There is also no one-size-fits-all approach to lymphedema. Compression, MLD, pneumatic compression, food choices and other treatments can affect people differently. The panel encouraged patients to introduce changes gradually, giving the body time to respond so it’s easier to identify what actually helps.Angela captured the mindset beautifully: “The condition is the condition. I’m not the condition. I’m the manager of the condition.”

What works one day may need adjusting the next. Adapting is part of managing a chronic condition—not a sign of failure.Angela encouraged patients to “become friends with your emotions.” Fear and desperation can make people particularly vulnerable to promises of quick fixes.With increased awareness of the lymphatic system has also come an explosion of products and social-media claims. The panel urged patients to do their due diligence, particularly when something promises to “cure” lymphedema or offers compression that isn’t medical grade or properly fitted. If something sounds too good to be true, pause. Research it. Ask your clinical team.Perhaps the most important lesson had nothing to do with treatment: Appreciate yourself.A flare doesn’t mean you did something wrong. A difficult day doesn’t mean you failed. Catherine reminded viewers that courage sometimes means making peace with difficult circumstances, while Angela added: “Be kind to yourself. Be your friend.”Instead of being at war with your body, appreciate all it continues to do for you. Love the legs that carry you toward the people you love.

Stay curious. Build your team. Advocate for yourself. Find your community. And above all, give yourself grace along the way.Find out more about how Lympha Press can help you manage lymphedema at www.lymphapress.comSHOW NOTE: Portions of the video are frozen due to technical difficulties, but the audio content provides valuable insights for listeners.

The August edition of the Lipedema Patient Roundtable welcomed registered dietician, Bonnie Newlin, MPA, MS, RD, CDN, CLT (@cravenourishment_thelippyrd), whose personal lipedema journey resulted in an astounding transformation and now a mission to help others manage and thrive with lipedema.

The discussion began with the mental strain of lifelong struggles with body weight and the importance of self-acceptance and not letting the scale define self-worth. “It’s about health – not numbers” was emphasized.

Newlin’s expertise in genetic testing that helps personalize managing inflammation underscored that what works for one person may not for another. Some thrive on ketogenic or low-carb diets, while others need more complex carbohydrates. The bottom line? Certain gene variants (e.g., PLIN1) can influence how individuals process fats and carbohydrates.

Electrolyte balance was discussed and the right balance of sodium, potassium, and magnesium can help manage fluid retention and bowel health. Creatine supplementation was discussed as beneficial for muscle strength and methylation, but Newlin cautioned that dosing should be individualized.

As a member of the Medical Board for The Lipedema Society, Bonnie discussed working on clinical guidelines for both surgical and conservative management of Lipedema, aiming to provide clear pathways for newly diagnosed patients.

Early diagnosis and increased awareness are seen as major wins for the community.

The importance of community, sharing experiences, and supporting each other was highlighted as vital for emotional well-being – and this is the cornerstone of the monthly Lipedema Patient Roundtables.

“You can’t change a body you don’t love, so love that body” was a closing message embraced by those who attended the live event.

Many thanks to Bonnie Newlin as well the active chatters who attended, and of course, our regular anchors:

· Cara Cruz (@PaleGingerPear)

· Angelique Charles (@TheLippyButterfly)

· Jenny Beaujean (@Jenny_Beaujean)

· Siouxie Boshoff (@lipedema.living)

· Brenda Viola (@BrendaViola_ViciCommunications)

For anyone interested in learning more about lipedema, the monthly Roundtables are a great way to learn more; and for those who have lipedema or lymphedema, please visit www.lymphapress.com to learn how our compression therapy that’s easy to live with can help you manage your condition.

The views and opinions expressed in this Patient Roundtable are those of the individual participants and do not necessarily reflect the official position of Lympha Press.

This video is intended for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider with any questions about your condition or treatment.

The August Research Roundtable welcomed Dhruv Singhal, MD, Director of Lymphatic Surgery at Beth Israel Deaconess Medical Center and Associate Professor of Surgery at Harvard Medical School, for an in-depth conversation about the rapidly evolving understanding of the lymphatic system.

Dr. Singhal joined Dr. Karen Herbst to explore why lymphatic anatomy remains far less understood than the arterial and venous systems, and how new research is helping clinicians identify the pathways the body may use to reroute lymphatic fluid after injury. The discussion examined the superficial and deep lymphatic systems, collateral drainage pathways, and the “double hit” hypothesis—the possibility that an initial disruption may leave a person dependent on alternative pathways that can later be compromised by surgery, radiation, injury, or other interventions.

The conversation also addressed lymphedema risk following lymph node removal and radiation, the importance of surveillance for patients at elevated risk, and ongoing efforts to prevent lymphedema through immediate lymphatic reconstruction. Dr. Singhal described how lymphatic mapping, volume measurements, bioimpedance, and long-term follow-up can support earlier identification of changes before symptoms become more advanced.

Additional topics included breast lymphedema and drainage, precautions involving blood draws and blood pressure cuffs, ICG-guided manual lymphatic drainage, the limitations of current lymphatic imaging, and the potential role of medications, wearables, pneumatic compression, and other emerging technologies.

Throughout the discussion, Dr. Singhal emphasized that lymphatic care is entering a new era of precision medicine—one in which prevention and treatment may increasingly be tailored to each patient’s individual anatomy and physiology. The Roundtable closed with a message of hope, reflecting the growing investment, collaboration, technology, and research transforming the future of lymphedema care.

This Roundtable was originally recorded live on August 3, 2026. The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of Lympha Press. The content is for educational purposes only and not intended as medical advice.

Watch more Roundtables from our Lympha Press Research Roundtables playlist on YouTube.