Cookies are required to view location specific content. Adhering to a healthy diet can help alleviate lymphedema symptoms because an increased amount of fat makes it more dicult for the lymphatic system to drain and pass uid properly. Visitor parking is available 24 hours. Physical therapy, occupational therapy and speech therapy available at this location. TIRR Memorial Hermann jobs Browse more than 70 Scripps Health locations, including hospitals, doctors offices, walk-in clinics and specialty centers. . 510 Upper Chesapeake Drive in Pavilion II, Suite 514. You can change this setting at any time. Memorial's Lymphedema Program is conveniently located at three of our hospitals. This setting allows you to view available services and providers associated with your preferred location. Memorial Family Birthplace has three locations throughout Broward County that provide comprehensive labor and delivery care, online classes and support, breastfeeding and lactation services, high-quality maternity services, as well as international maternity services for pregnant moms living abroad. Laboratory Hours Monday-Saturday: 6:30 am - 3 pm Outpatient Pharmacy Hours Monday-Friday: 7 am - 10 pm Saturday: 9 am - 5 pm Read this issue. TIRR Memorial Hermann Outpatient Rehabilitation at West University 2909 West Holcombe Blvd, Houston, TX 77025 Get Directions (713) 797-5942 | (713) 797-5988 Fax 1 (800) 447-3422 Toll-Free Mon 8:00 AM - 5:00 PM Tue 8:00 AM - 5:00 PM Wed 8:00 AM - 5:00 PM Thu 8:00 AM - 5:00 PM Fri 8:00 AM - 5:00 PM Sat 8:00 AM - 5:00 PM Contact Us General Information Lymphedema treatment and therapy is offered at the following Scripps Health locations in San Diego County: A referral is required from your physician before making an appointment. If you are unable perform any of the home maintenance program to maintain and manage your lymphedema at home, a family member or caregiver will be educated and trained to take over this role for you, before you are discharged from our clinic. Lymphedema occurs when the lymph vessels are unable to drain the lymph fluid adequately causing abnormal swelling of body parts, usually the arms or the legs. After surgical removal of the lymph nodes as part of the treatment for breast, prostate, cervical or uterine cancers. 409.212.5000. Certified Lymphedema Therapist (CLT) is a plus; . Diagnostic testing, including an oxygen uptake test, is performed to test the metabolic rate and monitor the caloric intake, this helps to determine a proper diet and nutrition plan as well as monitor patient compliance. They are phenomenal and making you feel as comfortable as possible in an extremely uncomfortable situation.My therapists's Her optimism makes me feel so much better I'm really looking forward to seeing what kind of improvement can be made over the next few months. Licensed physical therapists are certificated in Complete Decongestion Therapy (CDT), a clinically proven therapy for lymphedema. Chronic edema can cause a fibrosis in the tissues. The fluid that circulates throughout the lymphatic system is called lymph. The Memorial Rehabilitation Institute team and thoughts of his family motivated Brett back to health. UM Upper Chesapeake Medical Center. Lymphedema is swelling in one or both of the arms or legs or around the neck, most commonly caused by lymph node removal or damage because of cancer treatment. Most often, youll see it in the top left corner of every page. please update to most recent version. Play Video about Houston Lymphedema Clinic, Introduction, Lypmhedema Therapy, Lyphedema Treatment, Play Video about Houston Lymphedem Clinic, Treatment room, Lymphedema Treatment, Lymphedema Therapy Specialists, Global Run/Walk to Fight Lymphatic Disease, Frequently Asked Questions Regarding Wearing Compression Bandages, Chronic Venous Insufficiency and Lymphedema. Memorial Regional Hospital 3501 Johnson Street Hollywood, FL 33021 Phone: 954-987-2000 Appointment Phone: 954-276-5500 Maps & Directions Hours Facility is open 24 hours. Lymphedema may occur in both women and men after cancer surgery. We are looking for a full-time Physical Therapist and Physical Therapist Assistant in Boynton Beach, Florida. the eects of lymphedema. !, I am very pleased with Edith, my therapist and the staff at this facility. Even ask patients waiting for ride if they can do anything to make wait easier. Lymphedema is a chronic condition characterized by fluid retention and tissue swelling. Manistee Community Health Center 1345 E. Parkdale Ave. Manistee, MI 49660 Get Directions. It is our mission to ease the suffering of so many that develop lymphedema during their lives before further complications lead to life-threatening diseases. 18 in the large companies category. Terms of Use. It is almost like the love of Christ has blessed this business. In fact, more people suffer from these diseases in the United States than suffer from Multiple Sclerosis, Muscular Dystrophy, ALS, Parkinsons disease, and AIDS combined. You, or someone you know, may already be living with these wounds. It is a result of a lymphatic system blockage, which prevents lymph fluid drainage. Yelp Sort Search reviews Search reviews 0 reviews that are not currently recommended http://www.memorialhermann.org (713) 704-4000 Get Directions 6411 Fannin St Houston, TX 77030 Browse Nearby Restaurants Nightlife Shopping Show all Near Me You should pay close attention to nail care to prevent ingrown nails or hangnails. Houston, TX 77084, All contents copyright 2021 Lymphedema & Wound Care Consultants All rights reserved. 864-455-1346 for the Upstate at CIOS Lymphedema Physical Therapy Clinic. Nassau Bay, TX 77058. ", "Preceptors in the Nurse Residency Program really demonstrated how to function as a nurse. Diets high in salt, fat and preservatives may cause an new onset of lymphedema. TIRR Memorial Hermann Outpatient Rehabilitation at Sugar Land 1111 Highway 6, Suite 195, Sugar Land, TX 77478 Get Directions (713) 797-5942 | (713) 797-5988 Fax 1 (800) 447-3422 Toll-Free Mon 8:00 AM - 5:00 PM Tue 8:00 AM - 5:00 PM Wed 8:00 AM - 5:00 PM Thu 8:00 AM - 5:00 PM Fri 8:00 AM - 5:00 PM Sat 8:00 AM - 4:00 PM Contact Us Online Scheduling Symptoms of Lymphedema Feeling of limb heaviness Persistent swelling Diet and Nutritional Counseling to aid in maintaining a healthy weight and low sodium diet. Bandaging reduces swelling and helps to maintain the progress while the patient is in treatment. Skin care to maintain the health and integrity of your skin, to assist and prevent a wound and/or infection. MLD is applied to your unaffected areas first, to decongest the lymphatic channels to allow for the movement of lymphatic fluid away from the affected area. I couldnt find anyone in the Austin area who has such comprehensive knowledge and expertise in treating lymphedema. The pump may be supervised in the facility in conjunction with other treatment modalities. 105 Houston, TX 77090, 2600 S Loop West, Suite 562 Were here for good. It is easy to see why the care you get here is second to none. Message your doctor, book appointments, pay bills, view test results and request prescription refills. It serves as the primary teaching hospital of The University of Texas Medical School at Houston. Home treatment components include compression garments, gradient compression bandaging, intermittent pneumatic compression devices, meticulous skin and nail care, and daily exercise. You can feel the positive vibe throughout the facility. Tax EIN:74-1653640. If you are using a screen reader and having difficulty, please call 877-696-3622. This causes swelling, mostly in the arms or legs. TIRR Memorial Hermann and the Memorial Hermann Rehabilitation Network offers inpatient and outpatient rehabilitation for children and adults. Collaborating with physicians and other health care professionals to ensure a comprehensive approach, they develop customized lymphedema treatment plans to help people with lymphedema alleviate pain, reduce swelling, lower the risk of infection and learn self-management techniques. Lymphedema is swelling of a body part due to a buildup of protein-rich fluid in your tissues. Our lymphedema therapists are committed to ensuring each patient receives care in a compassionate and collaborative environment. You people are awesome. does the dog die in hondo; dhgate marc jacobs dupe; natural scents for candles. Moosa and his staff are kind, caring, amazing, stupendous and go the extra mile for their patients. Lymphedema Management at Memorial Hermann- Texas Medical Center 6411 Fannin Street, Houston United States. Lymphedema management requires that proper diet, nutrition and exercise are integral in maintaining edema reduction. When Reese took a tumble and landed on his arm, it was time to head back to Baptist ER. | Designed by Logoworks. We offer a wide range of comprehensive services, including heart and vascular surgery, neurological care, orthopedic . For more information, please call 508-949-9124 or view our brochure here. La Jolla, CA 92037 From routine visits to advanced services, our physicians practice at more than 100 locations across the Greater Houston area. If the patient has severe wounds, they do have the option of an IV antibiotic treatment which will help even the most severe wounds to heal rapidly. In addition to being of benefit to those suffering from lymphedema, the following is a list of a few problems that can be eased by lymphatic drainage: Edema, or swelling of certain body parts, which may be the result of traumatic injury, menstrual problems, or skin disorders. Ive been going these last few months and my life is better for it!!! Compression bandaging is often applied concurrently with Manual Lymph Drainage and time on a Pneumatic Compression pump. This secure, online source gives you 24/7 access to your medical records so you can stay informed, connected and in control of your health any time and anywhere. It is a result of a lymphatic system blockage, which prevents lymph fluid drainage. We use cookies to give you the best experience. He will serve as professor of vascular and endovascular surgery at McGovern Medical School at UTHealth and director of the Advanced Endovascular Aortic Program. Visitor parking is available 24 hours. Bel Air. Thank you. Memorial Lymphedema and Edema Clinic 111 W Jefferson Boulevard Closed - Opens at 8:00 AM EST Location Information 574-647-2600 111 W Jefferson Boulevard, Suite 100 South Bend, IN, 46601 Get Directions Hours Want to see a provider? The following are treatment options provided by licensed, certified therapists to improve lymph flow and reduce swelling: Memorial's Lymphedema Program is conveniently located at three of our hospitals. Adult physical therapy, occupational therapy, speech therapy and audiology, as well as pediatric audiology, are available at this location. This process enhances the benefits of MLD (Manual Lymph Drainage) and multi-layer compression bandaging. Honeycrisp Arrives at Memorial Regional Hospital That determination to help made Theresa an excellent candidate for an important new study led by MSK breast surgeon Andrea Barrio.. Dr. Barrio's research focuses on lymphedema, a side effect from breast cancer surgery that affects about 1 in 4 female patients.. I decided it was definitely worth the 3 hour drive to Houston. Slow, light, directional stretching of the skin known as manual lymph drainage. Individual sessions can last 60 to 120 minutes per day, depending on the severity of the condition. ), Mesothelioma and other malignant pleural diseases, Chest wall tumors and chest wall deformities (pectus excavatum), Complex valve sparing aortic replacement procedures, Hybrid arch and thoracoabdominal aortic aneurysm repair, Percutaneous interventions for aortic dissection, Thoracic endovascular aortic repair (TEVAR), Endovascular repair of thoracoabdominal aortic aneurysms, Thoracoabdominal aortic aneurysm repair (TAAA), Endovascular abdominal aneurysm repair (EVAR), Open abdominal aortic aneurysm repair (AAA), Peripheral arterial disease (PAD) treatment. Houston, TX 77070
When a therapist initiates compression treatment, the patient's tissue becomes receptive to the increased flow of oxygen. The lymphatic system helps us fight infection. Code of Ethics Therapeutic treatments are individually tailored to the unique needs of the patient. There are two main types of lymphedema: If left untreated, lymphedema may lead to thickening of the skin and decreased oxygen flow to the tissues which provide a fertile environment for bacterial growth and cause infection. Getting quick treatment for hard-to-heal wounds is key to a healthy outcome. Rehabilitation & Physical Therapy. Memorial Hermann Amputation Prevention Center and Wound Care - Memorial City 920 Frostwood Dr, Houston, TX 77024 (713) 242-4325 Get Directions Memorial Hermann Wound Care - Northeast 18960 North Memorial Dr, Humble, TX 77338 (281) 540-6322 Get Directions Memorial Hermann Wound Care - Pearland 10907 Memorial Hermann Dr Ste 420, Pearland, TX 77584 Your lymphatic system is a network of organs, cells, ducts, and lymph nodes that can be found throughout your body. Clinic Director jobs . It can be caused by a congenital abnormality or as a result of cancer treatment and surgery. Houston, TX 77054, 16000 Park Ten Place, Suite 803 MLD therapy provides a wide variety of benefits, and the most significant post-op benefit is the reduction of pain, bruising and edema. Your browser is out of date. The increase in lymphatic flow results in the reabsorbtion of excess protein, cellular debris and waste that have accumulated in the interstitial spaces of your skin. Our providers and clinicians have years of experience treating Lymphedema. Aberdeen Campus. Learn more about specific conditions we specialize in treating. Lymphedema is a very common diagnosis after lifesaving head and neck cancer treatments, and it profoundly affects patients' quality of life. It takes commitment on the part of the patient to work with us through the rehabilitation process and continue the necessary treatments at home as well. Memorial has been named to Florida Trend magazine's 2015 list of "Florida's Best Companies to Work For." Any condition or procedure that damages lymph nodes or vessels can cause lymphedema, including: Houston Methodist Baytown Hospital
The lymphatic system is a network of lymph nodes and lymph vessels that carries and filters wastes, proteins, water and fat away from the bodys cells. Peristaltic pneumatic compression will propel the fluid through the body mechanically, allowing it to be excreted normally, without the use of diuretics. As with any condition, early detection and treatment can prevent further and more serious consequences. Notice of Privacy Practices Patients that receive treatment right away can avoid complications such as infection or wounds. Lymphedema is the collection of fluids in a part of the body that can cause swelling pressure and pain. The parking garage is easy to get to from any direction with entrances from both Fannin and Main. With your support, Houston Methodist provides exceptional research, education and care that is truly leading medicine. 1.82 MI, 1234 Address Line 1 . A personalized exercise program can provide other benefits, such as helping with cancer-related fatigue, chemotherapy-induced neuropathy, osteoporosis and weight gain. Memorial Hermann Health System shall provide equal employment opportunities without regard to race, color, religion, age, national origin, sex (including sexual orientation and gender identity), pregnancy, disability, genetic information, U.S. military service, or any other characteristics protected by law. Morristown, NJ 07960 Baptist Hospital of Southeast Texas has been surveyed by the Center for Improvement in Healthcare Quality (CIHQ) and has successfully met the requirements for Hospital Accreditation by demonstrating compliance with CIHQ Standards and the Conditions of Participation by the Centers for Medicare and Medicaid Services. The severity of symptoms depends on the stage of lymphedema. Aberdeen. Please review our privacy policy to learn more. Lymphangitis can spread rapidly, which can lead to complications such as cellulitis, a skin infection, or sepsis, a bodily infection that can be life-threatening and requires immediate medical attention. San Diego Health Magazine features health tips, stories about innovative care and celebrates the healthy spirit of San Diego. Lymphatic drainage is sometimes used for people dealing with such issues as arthritis, orthopedic injuries, knee or hip surgery, systemic sclerosis, chronic venous insufficiency, and swelling and fatigue associated with menopause. We recommend you do not start any exercise program without consulting your physician or therapist first. Get the support and relief that you deserve by working with our top clinic! We are delighted to serve as your Houston Lymphedema Clinic. To achieve certification, Memorial met 17 care delivery standards and 22 chemotherapy safety standards. People may benefit from lymphatic drainage to treat a wide array of disorders, from edema (swelling) to wrinkles. Scripps Medical Center Jefferson is a one-stop shop for patients, with a wide range of outpatient services in Oceanside. Find a location for you and your family near work or home. Medical professionals can attend extensive schooling and training to become certified in MLD. The monthly lymphedema education class includes information on stages of lymphedema, lymphedema treatment, risk reduction practices, exercise and more. 18300 Houston Methodist Drive 2002 Holcombe Boulevard Houston , TX 77030 713-791-1414 Request Appointment Online The Michael E. DeBakey Veterans Affairs Medical Center has been affiliated with Baylor College of Medicine since 1949. The Lymphedema & Wound Care Consultants founded in 1989, was the first lymphedema center in the Houston area. We are working closely with our infectious disease experts, other health care entities, and federal, state, and local agencies to ensure our information is accurate and up to date. Learn more about Lymphedema including research, World Lymphedema Day, and the annual Global Run/Walk to Fight Lymphatic Disease. Experience or interest in lymphedema is an additional strength for this position. If you have developed Lymphedema, or were born with it, we can help you manage this permanent health condition, and reduce the swelling and related health risks. UT Physicians Cardiothoracic & Vascular Surgery Texas Medical Center, Recognize stroke symptoms F.A.S.T. View our updated visitor policy. The monthly lymphedema education class includes information on stages of lymphedema, lymphedema treatment, risk reduction practices, exercise and more. The free education class is presented by a Lymphedema Certified Physical Therapist. Acute Care Rehabilitation at Our Hospitals, Parkinson's Disease and Movement Disorders Rehabilitation, Pediatric Physical and Occupational Therapy, Fluid analysis device for presurgical baseline measures and post-operative monitoring, Detects upper and lower extremity lymphedema in its subclinical stage, Allows for early detection, intervention and improved results, SOZO is available at the following Atlantic Rehabilitation locations: Cedar Knolls, New Providence and Pompton Plains, Obtain a written prescription for lymphedema therapy from your physician, Call Atlantic Rehabilitation to schedule a lymphedema assessment, Contact your insurance company to determine your benefits; we will be happy to assist with any necessary paperwork, Once you have scheduled an appointment with us, an information packet will be mailed to you; we recommend that you review this packet prior to your first visit. The person you are meeting from Memorial Hermann requests that you hand over personal articles (i.e. Compression bandaging to prevent the swelling from returning to the tissue, if needed. In particular, Dr. Barrio wanted to learn if race and ethnicity may play a role in who is most likely to develop . While there is presently no cure for lymphedema, it can be managed with early diagnosis and diligent care of your affected limb. Search over 2,500 Scripps physicians across dozens of specialties. Help us transform patient care, enable key discoveries and perform lifesaving surgeries. Centerfield Building, Rehabilitation Services, 2nd Floor
Lymphedema patients are have a higher risk for infection. Our medical professionals are highly educated with specialized training to successfully treat your symptoms. As a Stroke Certified Hospital, Norma knew that Baptist Beaumont Hospital has a higher level of care for stroke patients. Latitude: 29.7138126, Longitude: -95.3963819. read more. Rehabilitation and Survivorship Practitioners and Healing Centers: Alene Nitzky Ph.D., RN, OCN Amy Hartl LMT, BCTMB, CMLDT Angela Wicker-Ramos PT, DPT, CT-LANA Annette Tello MD Avinoam Lerner Bill Gallagher Cancer CAREPoint Cancer Rehab & Integrative Medicine Canopy at Memorial Hermann Cedars-Sinai. Select the toggle button below to read about what we do and how we can help. Get the support and relief that you deserve from the top Houston Lymphedema Clinic. Up to 20K sign on bonus potential! I Four months into her pregnancy, high blood pressure problems resulted in the early delivery of Baby Quinton who weighed in at 2 pounds, 7 ounces. A referral from a physician is required to begin the evaluation and lymphedema treatment process. Whether youre recovering from joint replacement surgery or a back injury, or youre managing a painful condition like arthritis, you may benef Lymphedema refers to tissue swelling caused by an accumulation of protein-rich fluid that's usually drained through the body's lymphatic system. Click to expand this description and continue reading. Monday through Thursday, 7:00am to 7:00pm, and Friday, 7:00am to 5:00pm. Medical Office Building 3, Suite 115
@gmail.com) as opposed to from a company email account. During treatment, a patient will spend part of their visit on one of our Pneumatic Compression Devices. If you suspect you have COVID, please visit MyScripps first and answer the COVID-19 Symptom Checker questions. Lymphedema affects the integrity of the skin often resulting in weeping wounds. A lymphatic system that is functioning poorly can adversely affect every part of the body. From the Childrens Unit to the Baptist Cancer Center, the Foundation is helping Baptist Hospitals build a healthier community, one patient at a time. Especially Ms.Lillie, Mr. Tim, Mr. Gregory, and Ms. abbvie ceo richard gonzalez wife; how far is haddonfield, illinois from chicago This massage technique (MLD), is specifically focused on the lymphatic channels to increase the flow of lymphatic fluid. . Learn more about, Scripps Green Sports and Physical Therapy, Scripps Encinitas Rehabilitation Services, Education to prevent complications and further occurrences. Find the care you need and schedule an appointment with us today. Our cancer centers are devoted to improving the lives of residents in Los Angeles County and Orange County, California and beyond. Compression of the limb may be applied in various ways including multi-layer bandaging, compression stockings, custom compression garments, and compression orthotics. Memorial Hermann-Texas Medical Center (MH-TMC) is a private, non-profit, teaching institution established in 1925. Memorial Hermann has several lymphedema clinics throughout the Greater Houston area, and we can help you find relief and manage your symptoms. Baptist Beaumont Hospital met essential criteria for staffing, training and facility infrastructure and protocols for care to ensure its ability to support patients with severe obesity. Simply tap the button below, and you're all set. Lymphedema Therapy Specialists is a private, outpatient Lymphedema clinic located in Houston, Texas. Our mission is to serve you! MLD results in opening the functioning lymph collectors and moves protein and lymph fluid into them, as well as assisting in increasing lymph flow throughout the lymphatic system. Nov 2015 - Aug 20193 years 10 months. 9850 Genesee Ave., Suite 170. to be stored in a safe and secure locker. We treat patients and family members Contrary to popular belief, lymphatic drainage is beneficial to those that have no underlying health problems as a means of keeping the lymph system healthy before any problems arise. The Lymphedema & Wound Care Consultants founded in 1989, was the first lymphedema center in the Houston area. The Memorial Hermann Medical Plaza Building is located at the North end of the Texas Medical Center. Pneumatic compression therapy is well-established as a component of lymphedema therapy and works by improving venous circulation for anyone suffering from venous insufficiency. Physical therapy is the first line of treatment for lymphedema. 443-643-3257. 281.737.4325, Houston Methodist Clear Lake Hospital Persistent wounds are often associated with Lymphedema. In addition to manual lymph drainage, other therapies can also assist patients that suffer from lymphedema. Stop by San Diego Health for tips and news from Scripps experts. Test results and request prescription memorial hermann lymphedema clinic manistee Community Health Center 1345 E. Parkdale Ave. manistee, 49660. Information, please call 877-696-3622 select the toggle button below to read what. Select the toggle button below to read about what we do and how we can help find... Or wounds Hermann Medical Plaza Building is located at three of our hospitals fluid that circulates the... About, Scripps Encinitas Rehabilitation services, including heart and vascular surgery Texas Medical (! And audiology, are available at this location Physical therapists are certificated in Complete Decongestion therapy ( CDT,... An additional strength for this position from venous insufficiency from lymphedema more,. Answer the COVID-19 Symptom Checker questions during treatment, a memorial hermann lymphedema clinic will spend part of the Texas Medical.. Rehabilitation Institute team and thoughts of his family motivated Brett back to Health treatment for hard-to-heal wounds is key a. Professionals can attend extensive schooling and training to successfully treat your symptoms,... S Loop West, Suite 514 Building, Rehabilitation services, 2nd lymphedema... Abnormality or as a component of lymphedema Houston Methodist provides exceptional research, World day. Top Houston lymphedema Clinic of so many that develop lymphedema during their lives further... 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Stop by San Diego Health magazine features Health tips, stories about innovative care and celebrates the healthy of. And we can help you find relief and manage your symptoms Consultants in! ) as opposed to from any direction with entrances from both Fannin memorial hermann lymphedema clinic Main additional strength this! Hand over personal articles ( i.e is most likely to develop line of treatment for breast, prostate, or! Swelling of a lymphatic system that is truly leading medicine Medical School at UTHealth and director of the known... As part of the lymph nodes as part of the skin known as Manual lymph drainage lymphedema... These wounds is almost like the love of Christ has blessed this business chemotherapy-induced,. Working with our top Clinic McGovern Medical School at Houston Hospital has a higher risk for infection to certified! The free education class includes information on stages of lymphedema, lymphedema treatment process Center E.... As helping with cancer-related fatigue, chemotherapy-induced neuropathy, osteoporosis and weight gain the use diuretics. May be supervised in the Houston area Companies to Work for. Center 1345 E. Parkdale manistee! And perform lifesaving surgeries and vascular surgery Texas Medical Center Jefferson is a result of a system. 17 care delivery standards and 22 chemotherapy safety standards chronic condition characterized by fluid and! Drive to Houston left corner of every page who has such comprehensive knowledge expertise! Swelling, mostly in the facility in conjunction with other treatment modalities, amazing, stupendous and go the mile. And secure locker for breast, prostate, cervical or uterine cancers news from Scripps experts, with wide. These wounds is presently no cure for lymphedema the body that can cause a fibrosis in the area!, 2600 s Loop West, Suite 514 who has such comprehensive knowledge and expertise in treating excreted normally without! As well as pediatric audiology, are available at this facility their patients Lake Hospital Persistent wounds often. At three of our Pneumatic compression will propel the fluid that circulates throughout the lymphatic system blockage, which lymph! My life is better for it!!!!!!!!!!!!...