Dr. Katie Deming [00:00:02]:
You're listening to the Born to Heal podcast, and I'm your host, doctor Katie Deming. After 2 decades of practicing as an oncologist and caring for thousands of patients, I've seen firsthand how our health care system places obstacles in your path to true healing. My guests and I will bridge the worlds of western medicine and alternative healing to help you achieve optimal health. Expect to uncover new insights, share a few laughs, and maybe even shed some tears along the way. But most of all, we'll learn how to heal from within together. So let's dive into today's episode.Dr. Katie Deming [00:00:38]:
Hello, everyone, and welcome back to the Born to Heal podcast. I am very excited for today's episode, and it's gonna be a little different than other episodes because today, I have Desiree Despong, who is a certified therapist lymphatic expert with over 20 years experience and is also the founder and CEO of Medela Health and Flopresso. She is here today to join us and share with us really about lymphatic health as it relates to breast health and also breast cancer recovery. So Desaree, thank you so much for being here.

Desiree De Spong [00:01:21]:
Thank you for letting me join, Doctor. Katie. It's great to be here.

Dr. Katie Deming [00:01:24]:
I love it. So why don't we go ahead and maybe you can just start by telling us a little bit about what you have to share today and then and then we'll just jump right in. And one thing to note for people who are listening is that this has visuals with the recording as well. So if you're listening on a podcast, it's going to be fine because we'll explain what you're seeing and then we'll have links for there are some descriptions that Desirae is going to share and we will have links that you can go and watch those. But if you're also going to publish this on YouTube so that you can actually watch the presentation as well. So just wanting people to know it's a little bit different than our normal format. But Desirae, I'll let you go ahead and take it away.

Desiree De Spong [00:02:05]:
Thank you. Well, we say kia ora in New Zealand, so that means hello. And so today, I'm going to, as we said, deliver a PowerPoint presentation just to give some visuals because some people like to see that. And what I wanna just do today is just give some insight into the value of understanding how your lymphatic system works, but more importantly, the relationship to breast health and post recovery from breast cancer. It plays a very pivotal role. It's kind of like the underdog to the cardiovascular system, so we haven't learned a lot about it as in it's not educated on as much as what the cardiovascular system is. I just wanted to bring this into people's visual. I do a talk in New Zealand for the lymphedema group here every 2nd month and the knowledge of understanding its value has meant that they've taken a very engaged approach to their self care of looking after it because it is pivotal to that post recovery as well as to maintaining breast health.

Desiree De Spong [00:03:02]:
So I am going to share the screen and as doctor Katie said, for those of you that aren't visually watching this, we will try to ensure that I describe this beautifully for you. So the lymphatic system, I'm gonna talk about it being it's like the river of the body or an aquarium is another way of thinking about it, you know, because fluids in your body are working through what we call the tissue space, which is the environment that your cells sit in. If you can imagine the lymphatic system's like a vast group of rivers and streams flowing through the body. And as water carries sorry, rivers carry water, obviously, there's a nutrient load that comes with that. So from the vascular system, for example, it feeds oxygen and nutrients to that tissue space and then the lymphatic system's role is to transport that away. If we think of that further, if like a river, I mean, I remember being a young child and playing, we had a stream down the bottom of our property and we would always put in rocks and try and build it up into a dam so then we created a pond. This is very similar to the lymphatics. It's that if we're not maintaining that healthy flow, if we are building up those blockades, over time that fluid will build up which means then you've got a disruption that creates swelling.

Desiree De Spong [00:04:23]:
But more importantly, if you take it a step further, it's going to create stagnation. It's going to create an environment of fluids that's byproduct that we don't actually want it surrounding ourselves, especially when we're thinking about viruses and cancer cells, etcetera. That's when we want to know we've got the flow and that river working. We do have natural filtration systems and they're known as lymph nodes and lymph nodes have probably gained their notoriety more unfortunately due to cancer because we now understand that those do get removed at the time if they're involved in any way. They act as a real powerhouse of immunity. It's their job to receive fluid, so lymphatics. Once it goes into the lymphatic vessels, you know, lymph will go through at least one lymph node before it goes back to the heart, but it usually consists of a number of different lymph nodes. We have over 600 in the body up to a1000.

Desiree De Spong [00:05:17]:
Over half of those can be in your abdomen, and we have a significant amount up in the cervical, or in New Zealand we call it cervical nodes, which is around your neck area. These are their role is to manage the pathogens, the byproduct. They decide what to keep. In other words, a bit like going to the waste station, for example, you know, what do we recycle? What do we destroy? What do we keep? What do we keep moving through? And that's where it's got this immunity of different cells that are acting as your fighters. So we have, like, b cells, t cells, you know, it's a powerhouse to be able to clean that fluid so that as it moves through to the body, we're gonna go back to the heart and cleanse through the liver, and then you'll go and actually eliminate it whether it's through the urine bowel breath or sweat. They do range in size. I had the unique opportunity to be at Holy Redeemer in Pennsylvania and actually go in and watch breast cancer surgery. And, I watched a lumpectomy as well as a bilateral mastectomy and that was hugely insightful for me who works on lymphatics because you understand then what you deal with as a practitioner.

Desiree De Spong [00:06:27]:
I was able to actually feel the lymph nodes and they're a little bit, you know, bare just to keep it simple, soft, and squishy, and they do, you know, recover when you press on them. So it was helpful for me as a teacher because then I could feel that as I was showing people where their lymph nodes were actually was the reality. It wasn't just something I was making up or hoping I had it right. And so, you know, they do sit in and we've got a lot from a breast point of view. We, you know, that environment, you've got them in your armpit which is called axilla. You've got them running down the side where the wire of a brow would be, which is your pectoral. You've got them in your parasternal, which is in the just either side of the sternum, the chest wall. You have them what we call central or apical, which sort of runs on a diagonal from the above the collarbone down to the armpit.

Desiree De Spong [00:07:12]:
But you also have subscapular, which is ones around the back of the with the crevices, you know. Knowing over time, you get that extra fluid there that you don't want and so hangs over the bra. That's an area that we also hold lymph nodes. We've got quite a significant up to around about 60. I think one of the things that I hear a lot in clinical care was always because most of my clients are breast cancer patients, was I've had all of them removed and that was always a massive concern, but most people don't. It's a small collective amount sentinel node, which is just in the crevice of the arm, near the armpit that they take initially to be able to diagnose, and then they may take an auxiliary clearance. But you still have a significant amount of other lymph nodes to utilize and I think it's really important that we stress that because in that way people know that activating the lymphatics to work efficiently will then ensure that those lymph nodes that are still there can do this job of the cleansing and purification. As I said earlier, it's a powerhouse.

Desiree De Spong [00:08:13]:
We do know that when we increase lymphatic flow, we increase lymphocyte activity. What that means is improving your flow improves immunity. Keeping the river moving on a regular basis is important and when it comes to lymphatic self care, daily practice really does make a significant difference. Stagnation is the key that we don't want. Lymphedema is one of the biggest concerns post breast cancer. It usually occurs in that 1st year after surgery, but unfortunately it can occur at any time. I've had people that have had one lymph node removed get lymphedema. Some that have had 25 removed and never do.

Desiree De Spong [00:08:54]:
We still haven't worked out the exact science behind one. Some do and some don't. I'm going to talk a little bit about lymphedema later, but the key thing is recognizing that if the plumbing's blocked, we're opening ourselves up to change within the tissue space which then can lead on to things like lymphedema. There's 3 important factors on how we move lymph. I'm going to talk a little bit further on, but the key for me is 2 of them are movement, so it's through that surrounding skeletal muscle, so actually walking, yoga. Yoga is probably one of the best I've seen in research around helping with lymphatics when especially it comes to breast cancer, and it's about the key to get the actual pumping and movement. Unfortunately, the lymphatic system doesn't have a heart. It doesn't have a natural pump, so it is reliant on these factors.

Desiree De Spong [00:09:44]:
And the worst part is gravity works against us, so we're having to push it uphill to get it back to where it must meet, which is actually in the termini which is the point above your clavicle where it meets with right or left subclavian vein. There's these contractual smooth muscles called lymphangions and they help if you've got to see the visual here, you'll see these little valves. They're like a dam. The doors open and surge the fluid through and the lymphangion is between each section, and it's a little bit like squeezing a towel. It's like as you squeeze the towel, the fluid moves through. Now those tend to activate more when you're in parasympathetic. Now parasympathetic is our rest and digest state. Most of the time, it's when we're relaxed, we're not stressed, or we're sleeping, and that's why you'll see fluid go down at night because when you go to sleep, you've activated this and the body naturally being constrained.

Desiree De Spong [00:10:36]:
So rest is just as important as what it is exercise so that we can help the lymphatics. And I'm talking about rest in the sense of distressed as in going away from cell phone, whether it's meditation, breathing, all that, which leads me into the third one and it's actually the breath, the change in that thoracic respiration. I mean, I make this thing. I remember growing up as children going, I must, I must increase my bust and you would open your arms and splay your chest out. But when you think about that, our lymphologist, doctor Neil Piller who's based in Australia, it was one of the practices we teach is actually taking the arms out fully, expanding the chest out, and then coming back in and tucking in so that you're actually creating this pumping mechanism through your chest wall. We need to understand that there's only surface lymphatics in the breast area, so it is reliant and there's no muscle in breast tissue. So it's relying on that pectoral muscle to move to be able to pump lymphatics. So the breath actually helps it from pushing it up, especially in that lower abdominal up through a thoracic duct, which is a pipe basically a pipe system that's coming up to your left subclavian, and it's helping you move and expand that chest wall.

Desiree De Spong [00:11:52]:
And in my 20 years of working in breast cancer, most women I meet in that early stage are holding their breath. And I mean that not literally. I mean that emotionally, physically. It's like the chest wall isn't expanding and it isn't deflating because, I mean, if we just go back to the diagnosis, for example, it is a shock. It's like the car pulling out in front of us and we go. And so then the trauma sits in the sternum and so we don't breathe. And that's not always about abdominal breath. It's very good.

Desiree De Spong [00:12:23]:
Yoga breath is great, but it's also about getting that breath through the whole chest wall so that we can act as a pumping mechanism to move your lymph.

Dr. Katie Deming [00:12:32]:
Yeah. And this is actually really beautiful. So these 3 the three things that Desiree just described is one activity, moving our body, moving contracting of our skeletal muscles and moving the lymphatics that way. The second is contraction of the smooth muscle within the lymphatic vessel, which you're not going to be aware of necessarily, but then the third one in using your breath. And what I love about what you just brought up, both about the sleep, because I think a lot of people and a lot of doctors actually think this because this is what I was taught is, well, when we lay down, then gravity changes. But what you're describing is, yes, okay, gravity changes when we lay down so that helps probably with some fluid, but it's the rest, it's the stress. And this is a big piece of what I talk about on this podcast and then the breath as well. It's like, you know, we're not breathing.

Dr. Katie Deming [00:13:28]:
We're not we're in shock. There's that that when you have a diagnosis, the fear and all of that can be so contracting that not only does that increase the stress response, which decreases the parasympathetic activity, which is helpful for lymphatic flow, but we're also then not breathing and letting in that air into our lungs. And so this is just another example of how if we can reduce our stress, if we can increase the parasympathetic response, this helps us heal and lymphatics is one of those things. So I love how this ties into all of the other things that they're already hearing on this podcast.

Desiree De Spong [00:14:11]:
Well, I mean, we only had the breakthrough research come out about the lymphatics, which is the lymph and the lymphatics of the brain, basically, and without going too technical. But what they did find is that we need 7 to 8 hours sleep to drain the brain. Now think about that with brain fog, you know, especially when you're going through chemotherapy. I mean, going through menopause, I mean, you know, I can certify that you do do brain get brain fog there on and off. So, you know, but that sleep is again pivotal to that drainage system as well. So, you know, it's also about the longevity that's associated to good quality sleep. And then that's the key, isn't it? It's getting into that deep sleep, the REM, the the different cycles, and then seeing the value. And I know, especially if you've gone down chemo way or anything like that, it does disrupt the sleep pattern.

Desiree De Spong [00:14:58]:
So it's bringing in certain ways to shift that and to create that change. So I'm talking about it's almost like retraining the body how to sleep again. It's so valuable, but definitely from a lymphatic, it's significant. If we can get you back into parasympathetic, we can get the body to actually regulate between that fight flight and that rest and repair. The change to the lymphatic system is significant and that's why I always say if our internal systems kind of doing that all the time, it's always on the go, it's worrying. I mean, what we think we create often if we're worrying about something, it does come to reality or it does, and more importantly, not just your body can't distinguish between your brain stressing out about something and you actually needing to run from the mammoth that's preparing you all the time. My concern, especially when it comes to chronic health or cancer, is that you're never turning the switch off. The body's over stimulating everything.

Desiree De Spong [00:15:54]:
If we talk about cancer cells, it continues to grow. It's being able to just be present and it can sometimes be incredibly challenging. But the breath brings us back, especially if you do some breathing exercises, as in breathe in for 4, hold for 4, out for 4. Then what happens is you're too busy thinking about the breath. You can't worry about what's going on around you. So there is those valuable insights that we've learned that does, as I say, make a significant difference to health and well-being, but also for us from a lymphatic point of view.

Dr. Katie Deming [00:16:25]:
Yeah. Absolutely. The breath helps everything, right, when we breathe. And there's so many techniques that we've talked about on this podcast in terms of using your breath to activate the vagus nerve, which helps with parasympathetic response. So I love all of that.

Desiree De Spong [00:16:41]:
I'm always about the out breath, just letting go. Breathe out for as long as you can. You'll always breathe in, but the natural response, but it's that outbreak of letting go of what no longer serves you. I find if you do that through a straw, if you want to do it a really simple way, we've just seen significant power to that and how it can reduce anxiety and stress. There's a lot of research out there around breath now. It's not like it's a new thing. I know we need to breathe to live, but it's the quality of the breath that makes a difference.

Dr. Katie Deming [00:17:10]:
Absolutely.

Desiree De Spong [00:17:11]:
So the key to this is to keep that river flowing. We need to have I mean, just think about I know it's going to be a terrible analogy everyone, but what if you didn't flush the toilet? It really says it all, doesn't it? So you want to be able to continually keep fluid moving. And environmentally, we are exposed to more toxins now than ever. So it is a daily thing like being able to drain, especially even the face, you know, around the neck and throat area. Even that alone makes a significant difference and it opens up. We're doing some research and some new technology at the moment and this is specifically for women with lymphedema. But what's been fascinating is we study with what's called impedance, so it's a unit to measure your intracellular extracellular fluids and we're measuring quadrant change. What's the right arm doing to the left arm? Our technique that we're doing is particularly just around breast cancer cases.

Desiree De Spong [00:18:03]:
We're doing up now above the collar bone, down the central here into the armpit, down the side of the chest wall, into the sternum and the arm. We're seeing, just to give you an idea of how powerful the lymphatics can be, we're seeing a 0.1 liter, so change in legs as part of that therapy even though they're not doing any of the lymphatic drainage on the leg area. So just moving your lymph can have an impact on the rest of your body. So the more that we care about it, the difference it can make to the overall quality of your recovery.

Dr. Katie Deming [00:18:35]:
Okay. I just want to clarify with that one. So what you're saying is just with activity? Is that what you're saying? Just by

Desiree De Spong [00:18:41]:
moving or We're using a vibration tool that we're in prototype at this stage at the moment. But just by getting a just by draining, doing some sort of drainage, even just in your armpit, chest area, can have an impact on even your legs even though you've not touched them. It's a bit like, if you think about my analogy of the river before I came along and put some stones and I created a dam. If I take the dam away, it opens up the pathway so the rivers can flow again. The more that you can do on a regular basis, the more you're going to impact the overall of the lymphatics because you're giving it pathways now to move. There's no blockades to be able to stop the fluid from moving.

Dr. Katie Deming [00:19:21]:
Got it. So the work that you do on one area of the body is helping with the flow throughout the whole body.

Desiree De Spong [00:19:27]:
Correct. Here are some of the overall benefits of lymphatic drainage. Really, it is about moving fluid. There is a correlation between, as I said earlier, increased lymphatic flow, you increase lymphocyte activity, so that means improving immune response. It can help reduce everything from lymphedema, even autoimmune conditions will make a significant difference with health issues, not just breast cancer or any cancer. Joint pain, digestive complaints. There's a whole system in your gut as well that acts as an immune, these types patches which are immune little cells in your digestive system. It plays a significant role so you can start to see the value that it might play in breast health and also in post recovery from any cancer journey.

Desiree De Spong [00:20:14]:
Let's move on to breast health. We want to love our breasts. They are I mean, I've had 3 children. They've played an incredible role for me. As I see it for my kids, I was fortunate to breastfeed all of them and working in the industry as long as I have, there's a lot of emotion to it. There's a lot of the mothering aspect. There's a lot of giving. There's a guy called doctor Hammer.

Desiree De Spong [00:20:36]:
He was an oncologist in Europe, and I think he did something like, I don't know, 50,000 people. And he was gauging was there an emotional connection between breast cancer and emotion, and he did this with all cancers. But one interesting the most interesting aspect was with breast cancer was that the breast were all about giving out and not receiving in. So it was the overgiving. Right side was mail and work. Left side was usually your own, like you and your career and how you're looking after you or mother child. And I spent my 20 years testing that theory and I think it was about a 98% outcome when any time I asked them what was going on in their life for the last 7 years, that was really impactful and traumatic usually and it always came back to something within those zones. So the key I can have taken away from that is the value for women and men who get breast cancer is to remember about taking care of self.

Desiree De Spong [00:21:40]:
We do a lot of giving and we forget how much it's needed to give to self. We're only as good as we are in the sense of our health and well-being.

Dr. Katie Deming [00:21:49]:
We did a whole episode on German new medicine and Doctor. Hammer was not an oncologist, but an internist who But he developed testicular cancer and then started looking at his own patients specifically within cancer. So if anyone's interested in hearing more about this idea of emotional trauma being related to cancer development, that episode is with Melissa Sow in German New Medicine.

Desiree De Spong [00:22:16]:
Right. That's fantastic. I just want to talk about a little bit more about location of these lymph nodes. I talked about them before and if you're visually seeing this, you can see on the screen a bit more where they are located. But it's just understanding where they are and more importantly, the drainage pathways. So around the nipple area, if we're going in towards the chest wall, about 25% of the breast tissue drains into the sternum, into the parasternal lymph nodes and the rest will actually drain into that pit. So it's just getting a good understanding of if you're going to do any manual drainage to think about where you're sending it. Now in our training in lymphedema, we're often moving the fluid over to the the side that hasn't been affected.

Desiree De Spong [00:22:59]:
But my thing is I've got a similar attitude to PT, use it or lose it. In other words, we wanna make sure that both sides are working. We always would work from an lymphatic point of view, the side that's not affected or in the case of a bilateral mastectomy, the one that's least affected. We would always start there first and open up the pathways. Coming back to the river, I'm opening up the drainage pathway so I can get the fluid to move and then I go into the site that's been impacted and I'll work on that site after that so that I'm making sure that I re support the drainage pathways of what that side had been impacted by. We know we grow surface lymphatics. We do regrow those, but we've got to get blood flow. We've got to get the nutrients.

Desiree De Spong [00:23:45]:
We've got to get the oxygen in that area to ensure that we do. We do not want stagnation. What was really interesting is I was in a conference in Melbourne with a plastic surgeon and he had actually was trying to see if he can make human breast tissue. So in other words, get your cells, put them in a sand shaped capsule that he could then put blood cells in that. He was doing it with mice at the time and at the end of it, he showed us what it looked like and it was like a shape of a breast tissue. I don't know if he's actually going to advance it any further, but what was really interesting is when he opened it up, there was a lymph node. Now we have not seen anywhere scientifically to prove that lymph nodes will regenerate, but being that every other part of the body more or less does, it would not surprise me if we can, but we need to ensure that we work that environment to rebuild. Unfortunately, with surgical scars and the initial build up of getting cancer, that can impede the way the lymphatics is working.

Desiree De Spong [00:24:40]:
By going in and getting to know where they are and actually supporting the flow will increase not only septosynthetics as I said, but there is a chance that it could increase again lymph node development because we're still in early days of knowing if that's a reality. The main sites, as I said, are above your collarbone. They're down the sides. If you think from your collarbone on a diagonal to your armpit, there is lymph nodes. There is ones in under the armpit. Obviously, that's where they do the axillary clearance. As I said, down the side where the bra line would be is your pectoral. You've got parasternal.

Desiree De Spong [00:25:13]:
You've also got what's called apical, so women that have breastfed, you get this let down feeling. It's around that area, so about 3 to 4 fingers down from the collarbone. It's almost centralized to the nipple. And then there is some anatomy books that do show them at just under the breast, but I have not been able to validate that. But you do have them in your cubital, which is just above the elbow, and humeral, which is just as you're about to come down from the shoulder at the inside of the armpit, there's some sitting there called humeral. Those 2 play a big part too if you're having lymph edema in the arm. We need to make sure that those are moving. They get quite, I'm going to use the word pearly.

Desiree De Spong [00:25:53]:
You can feel the little lymph nodes in there when they're not actually draining sufficiently. The good old brass, I mean this is just a little bit of a funny, can we live with it, can't we live without it? But there is some research, especially post breast cancer, removing the wire. The wire can impede on that pectoral node to access a bit of a dam. They have found even in a hospital in Zurich that even a standard bra pressure can decrease the amount of lymphatic flow. My thing is we want to look feminine. We wanna be outside. We wanna be able to wear bras, but just every now and then, try and ensure that you can get the bra off, especially at home because it's all about what I call free flowing. There was some controversial research quite a while back where they said that if you wore bras 24 hours a day, you were a 125 times more likely to get breast cancer.

Desiree De Spong [00:26:43]:
It's more that think about really tight socks. You know, when at the end of the day, if you swell, you've got that build up of fluid. It's actually just a tourniquet. And often, you get to the end of the day and most women will go, oh, I can't wait to get my bra off because I feel so pressurized. It's just more about ensuring that you're wearing 80% of women do not wear the right size bra for starters. It's making sure that it's the right size, the quality fit and ensuring that you do have what I call time out from the bra just to allow the body to naturally move and then get those pectoral muscles working so you're ensuring you're getting that drainage. I think one of the issues I'm seeing is a lot of us sit at a table, right at a desk and we're working over a computer all the time and we're not getting that movement in our chest wall to what we used to. So our shoulders become hunched.

Desiree De Spong [00:27:31]:
We don't breathe as well. And then we've got a bra that's too tight fitting and we're just creating this buildup of fluid due to that.

Dr. Katie Deming [00:27:39]:
Yeah. And I don't know if you know this, but I had a company actually, I had a line of bras specifically for women who had sensitive skin from radiation and they were specifically long line with no underwire, very light support. But one of the things that is interesting for women with breast cancer is oftentimes they're prescribed a compression bra, right? So especially if they've had a mastectomy, any kind of reconstruction, and they're put in these compression bras, and oftentimes told to wear around the clock. Initially, you just want to know that these women, if your doctor has told you initially after surgery to wear a compression bra, this is not what we're talking about. You can follow what they've recommended in terms of how to wear that, but then after you're done with that compression, you know, finding time out of the bra and then going without or going with something that's very light support and and allows for that flow is is is important.

Desiree De Spong [00:28:40]:
That's a really good point. Thank you, Doctor. Katie. I the compression garments are provided for a reason. We're trying to minimize that buildup of fluid. So yes, that post surgical time is vital to wear that and sometimes people have to wear them for a lot longer. But just after that period of time, I have found that if we can get, you know, like jumping up and down on trampolines, it's not the nicest thing but it's about getting that chest wall moving and come back to what I said earlier. There's no muscle in the breast tissue.

Desiree De Spong [00:29:08]:
So we're reliant on that breath, pectoral movement, and opening up pathways. Now if if you're dedicated to every day doing some manual drainage or some sort of technique that you can get that lumps moving, then that will help offset that. But it's just, again, it's just another little thing that I found that if we're not wearing those, and especially the wrong fitted bras, that can be significant because they do get a lot of ridging around under the breast and into that pectoral area. Absolutely. Product toxicology, they are finding there was this really fascinating research done about 15, 20 years ago. I can get the journal information if you require it, but they actually found there was a 1000000 times more parabens in especially around the armpit than what they should have been. And I just wanna be mindful that, you know, what you put on your skin enters under the skin and therefore will impact on how the lymphatic system is going to function because the more toxicity you're putting into your body, the harder it is to work. Right? So it's more about just ensuring that what you're buying and what you're putting on your body is going to be something that's going to nourish it as opposed to give it more work.

Desiree De Spong [00:30:20]:
We have to be mindful of what's out there now. There is just such a different range. I know the the hoops that we've had to jump for through for us to get through FDA and all the rest, but there's a lot of cosmetic products out there now that don't go through any testing and we just have to be mindful of that.

Dr. Katie Deming [00:30:38]:
Absolutely. That is one thing I think that is simple to shift out of the products that we're putting on our skin. Personally, I've switched to using castor oil, which is an amazing moisturizer. I don't use any of the cosmetic products anymore, or lotions, or creams, any of that, because you can use that which is a natural product and no toxins and actually helps in many ways like break up scar tissue and can be very helpful. So absolutely.

Desiree De Spong [00:31:10]:
Yeah. No. Castor oil is phenomenal. It's been around for so long. And from a lymphatic point of view, we've always used it on the abdomen and liver. So, yeah, it has incredible quality. So and it is known to and it's I mean, I use it. I do cheat and mix it with a very cool product here in New Zealand called Scar Release which I use a lot in clinic.

Desiree De Spong [00:31:28]:
It's got essential oils and that's made by a company here and I just just give that little added value. Now that I'm getting a bit older, you're trying to offset the amount of wrinkles you get. Okay. The signs of lymphedema, the key for me is recognizing it early. We can always bring you out of the situation faster than if it's left for a period of time. I think that's just something I want to really get people getting to know the fact that there is certain signs that they can detect. So for example, you know, like your ring gets tight or you're noticing that your arm's heavy at the end of the day or you are because you don't always see the swelling to start with. It's not always the case.

Desiree De Spong [00:32:07]:
Or you're noticing more restriction in your shoulder, so lack of range of motion can be, you know, any sort of pain or aching. But even, believe it or not, like your socks and shoes, like, if you're starting to see more swelling in your legs, that can also be an indicator that your lymphatic system isn't functioning as well. Now, you know, the thing is is it's getting that advice early. And usually, in the process of cancer therapy, there is usually the availability within your medical system to be tested or seen or at least assessed so that you're capturing that at an early stage because it will make a difference to recovery. As I said earlier, it's usually that 1st year and a lot of post surgical swelling, I find, gets confused between, oh, it must be that over 6, 8 months later, but it's not because there's a build up of time and the tissue is changing, so the environment or the tissue space. That's always my concern that those we then get into different gene expression where you're starting to change that tissue environment which means it can lead on to lymphedema. The faster that someone can get some help means that there's a good chance that we can reverse that out and you can go on to not need what I call major medical intervention. The risk factors, obviously, if you've had lymph node dissection, that is, but not always the case.

Desiree De Spong [00:33:28]:
As I said earlier, I've seen some with 1 get it that have had lymph 1 lymph node removed and some that have had 20 and never. But there's always trauma associated to it, the extent of surgery. And, obviously, the surgical procedures, so how much scarring you've got, and then on you go on to the radiation as well can have an impact. So as more as I said, you can remobilize, get your range of motion, hang out with your PT, get to know what you can do to actually improve that, but do think about bringing in some sort of self care lymphatic drainage makes a significant difference as well.

Dr. Katie Deming [00:34:00]:
Well, and also there, I want to point out body mass index and weight. So it is one thing that we have control over is getting our weight to a healthy body weight for you is one of the factors that can reduce lymphedema. Like risk of lymphedema.

Desiree De Spong [00:34:19]:
Yes, It is. It is a big part, unfortunately. Well, I'm not too sure how you'd answer that, to be honest. I mean the thing is Unfortunately, unfortunately. Unfortunately, yeah. But it does play I should have raised that one. It really does it does impact significantly and the burden on the body. So for me, you know, the more that we can bring down the weight, the difference it will make to especially from an epidemic perspective as well.

Desiree De Spong [00:34:42]:
Yeah. But you know what? In my career, I've had so many people come to me and say to me, I diet correctly. I do everything right. I exercise, but I cannot budge this body weight. And you get them into doing lymphatics, like even on a vibration plate. You know, you bring them and bring them at home and use them, you know, things like that and they start to lose weight because the pathways get opened and the fluid can now move. And I have seen that quite a number of times. So obesity is an interesting thing for me.

Desiree De Spong [00:35:13]:
There is definitely people that they are what they eat or they are by the lack of movement, etcetera, but there has been a few that I've seen that there is this blockade issue going on and you start to open the pathways and they start to lose, you know, I'm talking pounds, quite quickly once we get the fluid moving.

Dr. Katie Deming [00:35:31]:
Yeah. No. I think that's beautiful that doing this work on improving your lymphatics can help with the ability of getting your body to an optimal weight. It's not just the blockage lymphatics, it's all the toxins. I think the epidemic of obesity, yes, it has to do with what we're eating and how much we're moving, but a lot of these toxins in our environment are making it hard for us to release that weight. So absolutely. And I love that you just called attention to doing some of this work may actually help with that issue as well. Not that it's like the primary goal, but just that removing those blockages helps with us to release the excess body weight.

Desiree De Spong [00:36:14]:
Yeah. So I'm going to just talk about some different drainage techniques and I'm just going to talk through some manual drainage, which obviously if you're only listening to this, I'll ensure that we get a little handout sheet. There are some really good people, like great demonstrations on Instagram now, and I'll make sure that doctor Katie has those as well so she can show you a different ones if you want to learn. But the key is daily, so I always encourage anyone if they're in the shower, for example, if they can make that part of their shower, then they'll do it every day. Or when you first get up or when you go to bed at night, if you make it a routine, then you'll remember to do it. In the first site that we always drain is a thing we caught and massage proximal to distal. So again, if you think about it, if I've got my rocks in the river and I try to push the fluid, like, you don't use to talk about a mile up, we we use kilometers, so I gotta think about this. A mile back, you know, you're just gonna push the fluid to that dam.

Desiree De Spong [00:37:09]:
You've gotta open the dam first. So the terminus which sits above our collarbone is where the lymphs meet. So it's often just a pump. So this is not massage, so it's not circular. It is a pump. It's kind of think of it, I'm pushing in and then I'm letting go. It's like I'm bringing a pressure and a release and a pressure and a release. We're working with lymph nodes, not necessarily the drainage of the surface lymphatics because that is more of an art.

Desiree De Spong [00:37:36]:
We've got to get that right. We've got to direct it right and send it to the right place. I'm just giving those lymph nodes a little bit of a compression and a release so we can pump them so that they can start to move some fluids. And normally, this is done 5 to 10 pumps. I want this to be a slow, not like I need to get this finished in a hurry because I've got to get to work and I must at least fit this in and say I can fit it in. Right? It's a pump release, and it should feel really lovely. And the amazing thing is you can actually start to feel drainage from your face. Your sinuses might open up just by pumping above the terminus.

Desiree De Spong [00:38:12]:
Then in the central axilla, which is from the collarbone down to the armpit, we're just going to now what you wanna do is drop your shoulder. You do not want your shoulder up high because it's now putting in a skeletal response or a muscular response of tightening. You wanna keep the shoulder beside that you're working on relaxed, and then it's just kind of a scoop. You're just scooping it up through that central axilla, and then we go into the armpit, and the armpit is like a scoop pump, and keep the shoulder drop. Now as I said earlier, if you're gonna do this correctly, you'll do the side that is actually not involved first so that we open that up and it can take the excessive liver flow. But even if you just pump your armpit to keep that shoulder dropped and you get in there and pump it, it's about getting all that tissue moving. It's mobilizing lymphatics. It's getting those nodes that are left to be releasing and getting that blood flow into that area to recover.

Desiree De Spong [00:39:06]:
We can come into the side of the pectoral. Now in a shallow scenario, I just use the base of my hand so that we have somebody come down from the thumb. It can just be a scoop up if you use a bit of soap. It's just trying to get the movement. The more that we can get movement into that parasternal, chest wall, breast tissue, the more blood flow we'll get. Then we can come into the cubital which is above the elbow. Again, it's just a pump release. Then you can effleurage which means basically sweep back up to the throat area.

Desiree De Spong [00:39:38]:
If we look at these different visuals, I'll be sending them through. I'm just showing everyone on the screen that there is the direction of how you're going to be doing these scoops and presses. And honestly, it only needs to be a 3 to 5 minute technique every day. Or when you're sitting watching the news or you watch some movie, you can be doing it then. The key is not to overdo it. I know that there can be a bit of frustration of I want to move that fluid and I've gotta move it now, and I'll sit there for 20 minutes and I'll get really tender. I don't want that. Love those lymph nodes is my attitude, but the, you know, we wanna be able to create movement but give it time to shift.

Desiree De Spong [00:40:18]:
You know, when we've been through such trauma like breast cancer and surgeries and that the body still needs time to adapt, so it's like loving your best friend. You're not going to go in there and push them around and make the move, you know, get up and keep moving and hurry up. You're going to be more like, okay, take it gently. Let's get you moving. Let's get you recovering. I want you to think of the same analogy when you work with your lymph nodes.

Dr. Katie Deming [00:40:40]:
And so with these, you're doing basically like 10 of these scoops or presses for each of these different areas starting on the side that is healthy and not affected by surgery if someone's had surgery, and then to the affected side, just for clarity.

Desiree De Spong [00:40:54]:
That's correct.

Dr. Katie Deming [00:40:55]:
Okay, perfect.

Desiree De Spong [00:40:56]:
Just from an anatomical point of view, the lymphatic system drains into the left subclavian. So if you have breast cancer, it's going to move over to that left side. So that is kind of the main point of where it meets the heart. So we always start left side as a rule in lymphatic drainage, but if you have had left breast cancer, then we are asking you to do the right side first just so that the pathway so it means that any overflow. So if the left side isn't able to manage it as well, hopefully, the right side can pick it up and move it back to the correct area through the left right lip. So right subclavian to the left subclavian. Now if you're not really into doing handwork and, you know, like it's just too hard, This is where I created this product called Flow Vibrate. Now Flow Vibrate, unfortunately, the look of it created a lot of controversy and because of just the shape of it, but it's more designed.

Desiree De Spong [00:41:47]:
It's got 3 different vibrations. So the idea was that vibration, like a vibration plate, helps move lymphatics in a very subtle way. So it's creating micro pulsations of the muscle and to be able to create stimuli. So the idea is is as you're sitting there watching a movie, you can just move this or place it in the locations of the lymph nodes and it'll create these mini pulsations to try and help the lymphatics move. It's also being used a lot in the beautician area of draining your puffy face, which is great from a glymphatic point of view. Releasing the jaw, it helps with the vagus nerve. A lot of people find when they use it at night, they want to go to sleep faster. But it's designed for those that just want a tool that's easy to use and Doctor.

Desiree De Spong [00:42:34]:
Katie will have the information for that if you're interested to learn more. But we have found that it's just great to be able to hold. As I said, you got 3 different levels of vibration. So it might be, for example, number 3 which is more intense would go into the armpit, but number 1 would be more the face because it's more of a lighter vibration. But it's all about a comprehensive way of just trying to help that body get fluid moving. The other techniques, we've talked about breath. Again, I want to come back to that. Just the vacuum effect of diaphragmatic breathing is again going to move that lymph to up to as much as 15 times more than the normal rate because the breath has to bring the lymph from the abdominal down into the legs up into the chest wall.

Desiree De Spong [00:43:18]:
So that the improved way that you breathe is going to make a significant difference. So I can't come back to that again, but it's a free one. It's a free technique. We can all do it. It's just improving the depth of breath that you do. I talked about movement. You can get the rebounders. You know, those are an oldie and a goodie.

Desiree De Spong [00:43:35]:
The key though to rebounding, you can do trampolining which is very good for you as well, but lymphatics, it's you actually stay connected to the mat. So your feet, it's more like you're pulsing from one foot to another or surging with both feet on the mat to create the technique to move limbs. Any sort of exercise, walking. If you can just walk, walk around the neighborhood. It's all going to make a big difference to lymphatics. Then yoga, as I said earlier, would be one of the best researched areas I've seen, especially when it comes to breast cancer and in relation to lymphedema and lymphatic movement.

Dr. Katie Deming [00:44:10]:
So with this, with the movement, what is your recommendation? Say someone was rebounding, what are the recommendations there from a lymphatic standpoint?

Desiree De Spong [00:44:20]:
We always say daily a minimum of 7 minutes. 5 to 7 minutes, we want to be able to get that movement. Anything when you're getting into the 20:30, it's more aerobic and you're starting to you'll start to maybe push a bit too much lymph. And the same with vibration plates. Vibration plates can be very, very powerful and they can sometimes make you feel a little bit, what I would call, you know, like you're detoxing just because it will start getting things. So just be mindful that we don't want to overdo it as well. A 5, 10 minute session might be all we need and then we build up slowly as opposed to that said, I'm going to go and do this and I'll get on it for 30 minutes and I'll all of a sudden go, Oh, I feel awful. I don't want to touch it again.

Desiree De Spong [00:44:59]:
So build up to rather than do a whole lot too soon.

Dr. Katie Deming [00:45:03]:
Okay. And then also same thing with breath work. Like how much breath work is needed to help activate the lymphatics? What would you recommend there?

Desiree De Spong [00:45:12]:
With the way the world is right now, I'd be doing it like and I'd be putting aside on every hour or few minutes just to have conscious breath because it's amazing how much you again, I'll come back to that analogy, hold your breath. Like it is quite, you know, become really mindful of that. When are you feeling anxious? When are you feeling like system's starting to get a bit wound up? That's when you engage the breath because it is the fastest way to get you down into back into parasympathetic, but it improves that quality of that chest wall lymphatics.

Dr. Katie Deming [00:45:43]:
Perfect.

Desiree De Spong [00:45:43]:
This is a yoga pose, legs up the wall. Obviously, you'll be going, yeah, that drains my legs, but it actually doesn't. It actually has quite a significant difference as well on anything from thyroid function, which is important when it comes to breast cancer, increasing energy. But what you tend to do is this is when you engage the breath as well. So your legs are elevated, your buttock tends to be up against the wall, be nice and relaxed, open up, breathe, and try to just be present in that moment because that whole activity will have a significant impact from, as I said, draining the legs. But because you're now in the abdominal area, you're in a state of relaxation, you can then propel that fluid up to that termini again. And last but not least, the goody oldy one is dry skin brushing. It's been around for a very long time but it does make a significant difference.

Desiree De Spong [00:46:30]:
You wanna get the right brush. It does have to be natural bristle. It is usually done pre shower so you're sloughing off the dead cells and the idea is not to make you redraw with it. It's just sweeping as opposed to scrubbing. And the idea is just to create again that stimuli, like the skin feels amazing afterwards. It can have a significant difference into how, you know, both vascular and lymphatics works if you do it on a daily practice. It doesn't have to be long. It can be, again, 3 to 5 minutes, but the impact can be noticeable just by being able to create that little micro pulsation again of those bristles.

Desiree De Spong [00:47:07]:
So that's my presentation and we can discuss questions, Doctor. Katie, if you have any.

Dr. Katie Deming [00:47:14]:
Yeah. Well, thank you so much for providing that overview. I think this is a question that a lot of women or an area that a lot of women have questions about. And like you said, it is an area that does not get a lot of attention. I mean, as an oncologist, you know, in a radiation oncologist specializing in breast cancer, we really were not taught how to help facilitate lymphatic flow. We're just taught how to identify it and then send people to the physical therapist to hopefully help with the treatment. But I think it's really important to know what the signs are, to catch it early, to do the prevention, to help with lymphatic flow, even if someone This talk was related around breast health specifically, but this is relevant for all of our health. The lymphatic flow in our body is just critical for our immune function and for filtration of our body.

Dr. Katie Deming [00:48:14]:
So I'm just really grateful to have you share your expertise because you have so much experience in this space and have seen so many people over your career, and then also in developing these products that are helping people improve their lymphatic flow. It's really helpful. So thank you so much for being here and chatting with us. And if people want to know more from you, where can they find you? And we will definitely drop the links for the descriptions of I think that you said there's some Instagram accounts on how to do this manual techniques that you were describing there. We will have links for that. But where can people find you and more information?

Desiree De Spong [00:48:57]:
So I'll be honest. I'm all over the show. So my I've got a personal website, desreagespong.com, and then our all our technology is under flowpresousa.com. And that was all the technology I developed from my career in lymphatics and, you know, we're throughout in a in a number of different areas. But I'm just started actually, I'm just, about to launch a podcast called Lymphatic Insights. So those that are more geeked out by lymphatics, you can start to hear from a number of different experts from explant surgeries, breast cancer surgeons, like just because I want to be able to highlight how important this system is and and show that there is a lot of information out there. It's just no one's really centralized it. But those are probably the easiest ways to get to me all on Instagram.

Desiree De Spong [00:49:40]:
I'm on Instagram as well. And, so kind of realizing I've got to step up and get a lot more information out there so we can help others to really see the value that the lymphatic at the end of the day, the emotional component of lymphatics is letting go. What do you no longer wish to hold on to? And I think that just sums it up beautifully whether it's the byproduct in the body or the emotional trauma or intergenerational trauma. I mean, they're still learning more about that, but for me, it's about if we can get people's lymph slowing. The reality is health will improve significantly in the world. It's going to take a little bit of education and time, so thank you for the opportunity to be here and speak on it. I really appreciate it.

Dr. Katie Deming [00:50:22]:
Absolutely. And I'm so excited about your podcast because I think that this is an area that people really are craving more information. So I think that that is amazing. When is the podcast scheduled to release?

Desiree De Spong [00:50:34]:
So we launch next month. We're probably officially about the 3rd week in September. And so, yeah, we got a variety of different people coming on, which I'm excited about because, you know, I think that range of knowledge is so important. Especially, like, as I say, having breast cancer surgeon and explant surgeon as well, just being able to talk about lymphatics from a surgical approach and just understanding more. I mean, we've got naturopathic doctors, medical doctors, so, very excited to be able to bring that knowledge so that the world sees the value it holds. But, you know, more importantly, it is a day to day commitment to move limbs, but at the end of the day, it doesn't have to be complicated because you're probably doing it in your own little way. It's just you hadn't realized to the degree where the value comes. And I just think if we can get the word out that lymphatics plays a really important role in your health and well-being, we'll make significant shifts in people's health and well-being.

Desiree De Spong [00:51:27]:
That's my hope anyway.

Dr. Katie Deming [00:51:29]:
Oh, yeah, absolutely. Well, and by the time this episode comes out, your podcast will be released because this won't come out until about October. So we will link to the podcast there. So if you are interested in learning more from Desiree, I recommend that you follow her because she is just a wealth of knowledge and information. And thank you so much for being here. We really appreciate you sharing your knowledge with all of us.

Desiree De Spong [00:51:50]:
LS: Once again, thank you for the opportunity and to everyone out there, move your limbs.

Dr. Katie Deming [00:51:54]:
Thanks everyone.

Dr. Katie Deming [00:51:58]:
Thank you for joining me on Born to Heal. It's been a privilege to share this time with you, and I hope that today's episode has offered you valuable insights on your journey toward optimal health. Please consider subscribing, sharing this podcast with your friends, and leaving us a review. To learn more about how you can work with me, please visit katydemming.com. You can find additional resources in the episode show notes linked below, And remember to join us next week as we continue to explore more holistic approaches to healing. Until then, this is doctor Katie Deming reminding you that just like me, you were born to heal.