Less Stressed Life: Helping You Heal Yourself

#381 Lipedema, Lymphedema and Cancer with Jean LaMantia, RD

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This week on The Less Stressed Life, I’m excited to welcome Jean LaMantia, a registered dietitian, cancer survivor, and expert in lymphedema, lipedema, and oncology nutrition. Jean sheds light on these often-overlooked but common conditions, sharing the key differences between lymphedema and lipedema, the emotional challenges they bring, and how an anti-inflammatory diet can help manage symptoms and improve quality of life.

She also shares her personal journey with lymphoma at 27 and offers advice on how women can advocate for themselves, find the right resources, and take action to feel heard and supported in their health journeys.

KEY TAKEAWAYS:

  • What lymphedema and lipedema are and how they differ
  • Lymphedema affects 10 million Americans—more than Alzheimer’s and Parkinson’s combined
  • Lipedema impacts 1 in 10 women but is often misdiagnosed as obesity or cellulite
  • An anti-inflammatory diet reduces inflammation and supports lymphatic health
  • Protein intake is essential for muscle health and lymphatic flow
  • Seek out a certified lymphedema therapist for support and guidance
  • Early intervention is key to managing symptoms and slowing progression
  • A diagnosis brings relief but can also come with emotional challenges

ABOUT GUEST:
Jean LaMantia is a registered dietitian, cancer survivor, and author of three books on lymphedema, cancer, and intermittent fasting. She created Lymphedema Nutrition School and Lipedema Nutrition School, online programs designed to help individuals improve their health through diet and self-care. Jean also offers professional CE courses, short programs, and webinars to educate dietitians, lymphedema therapists, and individuals on managing lymphedema, lipedema, and cancer. Based in Toronto, Canada, she runs a virtual private practice and shares valuable resources on her blog, https://jeanlamantia.com/cancer-bites-diet-blog/.

WHERE TO FIND:
Website: https://jeanlamantia.com/
Instagram: https://www.instagram.com/cancer_lymphedema_dietitian/

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Podcast Instagram: @lessstressedlife
YouTube: https://www.youtube.com/@lessstressedlife
Leave a review, submit a questions for the podcast or take one of my quizzes here: ****https://www.christabiegler.com/links

SPONSOR:  
Thanks to Jigsaw Health for sponsoring this episode! Try their MagSoothe or MagSRT for better sleep and less stress. Use code LESSSTRESSED10 at JigsawHealth.com for 10% off—unlimited use!

[00:00:00] Jean LaMantia, RD: what lymphedema is, it's chronic, there's no cure, there are, some surgeries that are now becoming more available, but really not accessible to nearly enough people.

[00:00:13] Jean LaMantia, RD: But otherwise it's chronic and you manage it. Lymphedema is a connective tissue disorder. It's also called a fat disorder. And it, this primarily affects women. 

[00:00:27] Christa Biegler, RD: I'm your host, Christa Biegler, and I'm going to guess we have at least one thing in common that we're both in pursuit of a less stressed life. On this show, I'll be interviewing experts and sharing clinical pearls from my years of practice to support high performing health savvy women in pursuit of abundance and a less stressed life.

[00:00:56] Christa Biegler, RD: One of my beliefs is that we always have options for getting the results we want. So let's see what's out there together.

[00:01:14] Christa Biegler, RD: Today on The Less Stressed Life, I have Jean LaMantia, a registered dietitian, cancer survivor, and author of three books on the topics of lymphedema, cancer, and intermittent fasting, which is a huge accomplishment. Side note, she is also the creator of daily and weekly journals to help individuals with lymphedema, lipedema, and food sensitivities track and learn about the impact of diet and self care on their health.

[00:01:35] Christa Biegler, RD: She's also the creator and facilitator of Lymphedema Nutrition School and Lymphedema Nutrition School, two online programs to help people living with these conditions improve their health, and has also created a professional CE course for dietitians and lymphedema therapists to help educate and advocate for nutritional management of lymphedema.

[00:01:51] Christa Biegler, RD: She's also created other short courses and webinars on these topics, cancer and complementary therapies. She's over here dedicating her life to this. So welcome to the show, Jean. 

[00:02:00] Jean LaMantia, RD: I know. Thank you. Thanks for inviting me. 

[00:02:02] Christa Biegler, RD: Yeah. So I met Jean informally at a conference a couple of months ago, and she was speaking with another colleague and friend, Leah Levitan, who has been on the podcast and will be back soon, who is a lymphedema therapist.

[00:02:15] Christa Biegler, RD: And Jean spoke in that about lymphedema. And when we've got two words that seem similar and have a little bit of overlap, there can be some confusion. And one of the things I took away from Jean's talk, of course, is that like most people don't even know that this exists. And as most people want, they want validation.

[00:02:34] Christa Biegler, RD: So we're shining a light on a lesser known condition and to bring us all to the same page and to make. More, I always think stories help. And so I want to hear about why Jean is dedicating her life to this, like where this has fit into her history. So often our own stories are what changes the trajectory of our life.

[00:02:52] Christa Biegler, RD: So tell us a little bit about why your entire life is pretty much dedicated to these topics now. 

[00:02:59] Jean LaMantia, RD: Yeah. I love that you're starting with that because I don't actually have lymphedema or I definitely do have a personal connection. And back when I was 27, I was diagnosed with lymphoma, which is a type of cancer.

[00:03:16] Jean LaMantia, RD: In my case, I had the lymph nodes in my neck and under both arms and the middle of my chest that were affected. And the one in the middle of my chest was 15 centimeters across. 

[00:03:26] Christa Biegler, RD: Wow. 

[00:03:27] Jean LaMantia, RD: It does have solid masses, but it actually is considered a blood cancer. And before I could receive my treatment, for people who've had cancer, know someone with cancer, you have to go through staging.

[00:03:39] Jean LaMantia, RD: And my cancer was growing very quickly. And I had to have, a biopsy, and then wait a week for the pathology results, and then wait a week for a CAT scan, and then, it just kept By the time I finally Went to the hospital for my bone marrow test. My lungs were so full of lymphatic fluid I could hardly breathe and it was like, I could just two words at a time That's all I could get out and I was 27 I had been like going to the gym and doing a one hour robots class and weight training and All of this stuff, and I could hardly breathe at this point, and what I realized was happening is that my lungs were filling up with lymphatic fluid, likely because of that large mass in the middle of my chest.

[00:04:25] Jean LaMantia, RD: The lymph fluid should normally drain, from your fingertips in, from your toes up, and from your head down, and it drains to this area here, called the terminus, the area just above the collarbones. And mine wasn't, it was going into my lungs. And essentially what was happening is I was drowning in my own body.

[00:04:41] Jean LaMantia, RD: So crazy. Walking around. 

[00:04:43] Christa Biegler, RD: Crazy as 27. I just have to know how this kind of onset, if you started to have noticeable pain in these lymph node areas that were, where you had these masses and then they started to protrude and you saw them, like what else was happening? And how long? Who knows if we're very self aware at age 27, I have no idea, right?

[00:05:03] Christa Biegler, RD: And this was probably quite some time ago, but tell us how that started to unfold when you really started to notice these things. 

[00:05:11] Jean LaMantia, RD: So it was in the fall time around September where I noticed I had this stiff neck. Yeah. Oh, yeah. Oh, just wasn't getting out. And I just thought maybe I'd slept with the window open.

[00:05:24] Jean LaMantia, RD: Maybe I slept funny. And at the time I was already a dietitian. I had done my four year honors degree and I'd done my internship. I was actually doing my second job, my second kind of temporary full time job. And I was working at a diabetes education center. So I was dietitians and nurses and there was a social worker.

[00:05:44] Jean LaMantia, RD: And I remember saying, oh, the stiff neck. And then those nurses that I was working with were like, Jean, you better get that checked out. You keep complaining about that stiff neck and it's not going away. I'm like, okay. You can't get away with anything with these nurses. So I went to my family doctor who was just, didn't know me very well because I was new to this city.

[00:06:04] Jean LaMantia, RD: I just moved there for the job. And one thing I could say about this stiff neck, it wasn't going away. And then the other thing I could say is that if I had alcohol, and there was a dietician friend of mine PhD in nutritional epidemiology. But we used to go shoot pool and, have a beer. And if I did that, the pain in my stiff neck would radiate down my arm and my arm would feel painful and, but numb and tingly at the same time.

[00:06:32] Jean LaMantia, RD: And I told her about this and she said, that makes absolutely no sense whatsoever. But she did an x ray, nothing ever came back to me. And then shortly after that, my job, which was a contract, was finished. So I went traveling, I wanted to learn how to speak Spanish, so I went to Mexico and I. I lived with a Spanish Mexican family and went to school and then I traveled, through Central America.

[00:06:56] Jean LaMantia, RD: I had a very adventurous spirit. And I was very tired and my host father kept saying, Oh, all the foreigners that come here, they're always tired. It's the altitude. Okay. And then also I just stopped drinking because it would hurt. And so finally when I got back home, I was in a shopping mall and there was a blood donor clinic and I thought, okay, I've given blood four times before.

[00:07:19] Jean LaMantia, RD: Let's just. Do the blood donor clinic. So I did my blood donation and then right after that I'm like, oh sore throat. Oh my god I'm getting sick. I know I'm getting sick. So when I went home This was now around Easter time and it was a good Friday And when you know This sounds like you need antibiotics go to the walk in clinic and I went and they said you've got bronchitis Which I thought was a little weird.

[00:07:45] Jean LaMantia, RD: But anyway took the antibiotics by Monday. I was not better And then I went to my family doctor that I had grown up with, and he did a chest x ray. And that's the only time that man has ever called me at home. A couple days later called and said, I'm going out of town, but I need you to see this other doctor.

[00:08:02] Jean LaMantia, RD: I can't wait. And that was the beginning of the cancer diagnosis. And what I realized when I started reading about lymphoma, Is I saw it said it sometimes reacts to alcohol. I'm like, it was like this light bulb moment. That's what that thing was back in September. And so it had been in my body that whole time.

[00:08:26] Jean LaMantia, RD: But I think what did it when I gave that blood donation, my immune system was so compromised that it took over. And that's why in that time, by the time I went for the bone marrow biopsy, it was a month. And it was just growing the nodes were coming out of me my neck, I could Wow. Hold my arms together, I could feel it, and then this mass here, which was coming out of my body, it was like the movie Alien and I still have, I don't know if you can see this discoloration here, where these blood vessels were pushed closer to the skin, and that's from the tumor.

[00:09:02] Jean LaMantia, RD: But I think that's why it just suddenly was like wildfire. And everyone could have cancer cells in their body, But their immune system keeps it in check. And I'm not sure if you've seen this yourself, Christa, but you might know someone who has a cancer diagnosis and they'll tell you, Oh, this couldn't have come at a worse time because I'm just getting divorced or my son's dropping out of university or, my mother died or my dog got hit by a car.

[00:09:27] Jean LaMantia, RD: It often comes on the tail of some other trauma. And a lot of times that's your immune system just crashing. The cancer cells are like, okay, there's no more regulator here to keep us in check and it just explodes. That's what happened to me. 

[00:09:43] Christa Biegler, RD: Yeah, we see that. I've had Dr. Paul Anderson on the show kind of painting a picture between autoimmunity and cancer.

[00:09:50] Christa Biegler, RD: And that's a bit of a common denominator. There's usually some big chronic acute that turns chronic stressor, right? Because the definition of chronic, is official, at least when I was in clinical care was officially more than a month. If the stressor hangs on for a little bit longer, right?

[00:10:04] Christa Biegler, RD: It can just allow a lot of immune things to activate and cause trouble, whether it presents as cancer, whether it presents as autoimmunity, and really humbling, when you're 27, 28 years old, it's humbling to anyone at any age. I remember when my friend was diagnosed with breast cancer a couple of years ago, and because I felt like we were similar age and I knew her very personally, I just took it very personally.

[00:10:27] Christa Biegler, RD: All of this is an emotional thing. So yeah. Wow. First of all. And 

[00:10:32] Jean LaMantia, RD: yeah, at 27, you have that feeling of invincibility, right? Eventually you're going to die and but it seems so unexpected then. But then when that happens at a young age, it changes your outlook from then on.

[00:10:45] Christa Biegler, RD: And I also feel like a sense of real optimism and positivity because it was growing very fast. I don't know how many years this is. Ago this was, but quite a while, I would guess, but more than a decade, I would assume, right? And so I think that this, some positives is that, wow, you had very fast growing cancer.

[00:11:04] Christa Biegler, RD: Here you are to tell about it, to write three books, to do these things. And so I feel very optimistic. And I wonder what you credit, your one provider, and I wonder what he saw on the x ray exactly that made him refer you on to, I assume, oncology. 

[00:11:19] Jean LaMantia, RD: Yeah. Yeah. He saw the mass in my lungs.

[00:11:22] Christa Biegler, RD: Yeah. 

[00:11:23] Jean LaMantia, RD: And I will point out, because people listening might be concerned, I did call the blood bank and say, I gave the donation at this time, do not use my blood, because I'm sick. They think I have cancer, don't use it, yeah. Just in case everyone thought I contributed that to the blood supply. 

[00:11:41] Christa Biegler, RD: Yeah. On that note, when you were telling about having your blood drawn, I was waiting to find out, I get my blood, but there's not, and there are some screening tools, but there's really probably nothing that would tip them off around that.

[00:11:52] Christa Biegler, RD: And and I don't know, maybe they do some testing afterwards and maybe it varies. I don't know what the criteria is, if they're international or national, but here you are, Yeah. Yeah. And so you had this experience with the lymphatic fluid filling your lungs. And paralyzing your life pretty much. So that's where we are in the story.

[00:12:09] Christa Biegler, RD: And I don't know if with this lymph fluid in your lungs, and such an interesting thing because we usually ignore our lymphatics until they're causing trouble for us, right? It's the system that doesn't get a lot of airtime in all of our medical education and anyone's medical education from my knowledge.

[00:12:26] Christa Biegler, RD: And so I can't totally be hanging. What happened next? You had this lymph fluid in the lungs, anything. What, is there any more to this? There's a lot more to the story. There's a lot more to the story, but is there anything to wrap that part with a little bit of a bow before we jump into the difference between Lipedema and Lymphedema?

[00:12:43] Jean LaMantia, RD: I had come from out of town to the cancer center and they said, yeah, we're admitting you. You're not going home. They did a thoracentesis, so they drained that lymph fluid through my back, 

[00:12:53] Christa Biegler, RD: and they, I remember 

[00:12:55] Jean LaMantia, RD: turning around, because you lean over in the hospital bed and they tap it out, and I remember turning around and seeing like two big bottles of this murky looking liquid, and they said, we still have one more staging test to do, a gallium scan, but we're not waiting, we're starting your chemo right away.

[00:13:10] Jean LaMantia, RD: So I got the chemo, I think, the next day or the day after, and yeah, and then I finished with six months of chemotherapy. And then a month of radiation, and then began my survivorship. And it, to answer your question, it was. Three decades ago, it was 30 years ago. 

[00:13:29] Christa Biegler, RD: Wow. Do you think that your age at that time had any positive influence on your outcomes?

[00:13:35] Christa Biegler, RD: Being young or being, do you have any opinion about that? 

[00:13:39] Jean LaMantia, RD: Yeah, I think it, for sure. Lymphoma, whether it's Hodgkin's or non Hodgkin's, has two clusters. It occurs in young adults and then it occurs in, over 65. 

[00:13:49] Christa Biegler, RD: Wow. 

[00:13:50] Jean LaMantia, RD: And I think, being on the younger side there, I think it helped.

[00:13:54] Jean LaMantia, RD: Yeah. I think, people always said, Oh, you have such great attitude, so maybe that helped as well. Yeah, whatever it was, I'm just, I'm grateful and here I am three decades later, still go with you. 

[00:14:07] Christa Biegler, RD: Yeah. Okay. So now you're over here writing books, serving people with the book. Lipedema and lymphedema in cancer.

[00:14:13] Christa Biegler, RD: So these words give us a quick rundown on lymphedema versus lipedema. 

[00:14:21] Christa Biegler, RD: So a while back my college aged daughter shared with me that she was tossing and turning and waking up several times per night after a period of stress. We started her on magnesium and her sleep immediately improved. I personally think magnesium should be your first thing to try if you're having trouble sleeping or staying asleep, especially tossing and turning, and it's a no brainer if you have any restless leg issues.

[00:14:46] Christa Biegler, RD: The thing about magnesium is that there's a lot of types of magnesium that will give you symptomatic relief, but I like to steer my clients and loved ones to a more absorbable form of magnesium, because most big box magnesium is magcitrate, and that will push bowels, but it can be damaging to your teeth if it's used daily and it's not the most Rather, Jigsaw Health makes one of my favorite great tasting magnesium powders called MagSue that has magnesium glycinate, my favorite calming and absorbable type of magnesium. It's available in both a great tasting powder and to go packets, and they also make a product that's great for slow release, especially if you have restless legs, called MagSRT.

[00:15:27] Christa Biegler, RD: So, If you are not falling asleep easily or if you have disrupted sleep, you can try at least 200 milligrams of great magnesium like MagSoothe or MagSRT, especially if you have restless legs. It works better to take this at least 20 minutes before you go to bed to allow it to kick in and you can get a on All of Jigsaw's amazing products, including MagSooth at Jigsaw Health with the code LESSSTRESS10.

[00:15:52] Christa Biegler, RD: Now you can use LESSSTRESS10 as many times as you want with every order at Jigsaw Health, which is honestly pretty unheard of with coupon codes. So enjoy the magnesium from Jigsaw with my code LESSSTRESS10. 

[00:16:07] Jean LaMantia, RD: So the term edema means a fluid buildup. So someone might have edema because their ankles are swollen, but you don't notice that. You notice that from the blood vessels in the legs have failed or the heart has failed or the kidneys or the liver.

[00:16:25] Jean LaMantia, RD: But lymphedema tells you that it's a fluid buildup of lymphatic fluid. And just to give your listeners an idea what that is, because you're right, we don't get good education on that. So when your heart pumps the blood out the aorta, that blood leaves the aorta and then that spreads out into different arteries.

[00:16:47] Jean LaMantia, RD: And then those arteries become smaller and smaller in diameter and they become arterioles. And then the arterioles pass through capillary beds, and it looks like this if you ever see drawings of it. Goes through the capillary beds, and then on the other side are venules. And the venules pick up the blood, and that turns into then, they grow in diameter and become veins, and then the blood returns back to the heart.

[00:17:10] Jean LaMantia, RD: But as that blood goes through the capillary beds, there's different estimates. Some say 10 to 20 percent of the blood fluid leaks out. Some say it's a lot higher. Whatever amount of fluid that leaks out, which is just like the blood plasma, it gets picked up by the lymphatic system and taken back to this area here and put back into the bloodstream.

[00:17:33] Jean LaMantia, RD: So it's very important for the vascular system. And we learn all about the cardiovascular system and how important it is, but we forget to learn that the lymphatic system is part of that and it helps return that fluid. Let's just take cancer for example and breast cancer, although it could happen with any type of cancer.

[00:17:57] Jean LaMantia, RD: Say a woman has breast cancer and they're going to remove some lymph nodes from the armpit and that'll either be through an axillary dissection or a sentinel node biopsy. But there's no lymph nodes missing and there's scar tissue there. There was radiation, so now there's scar tissue from the radiation.

[00:18:17] Jean LaMantia, RD: And what can happen is that lib fluid, which is supposed to drain up the arm, which happens all the time, but let's just say there's a scratch or there's a burn or there's some type of infection in the arm, and now the body has called all the white blood cells to that area. So now there's all kinds of white blood cells, which get there through the lymphatic system.

[00:18:37] Jean LaMantia, RD: And now once the infection is taken care of, it, they try to drain and they can't drain because, essentially the bridge is out. There's a bunch of scar tissue, and then everything gets trapped in the arm. And so that's lymphedema. It's described as a lymph stasis, but just like stagnant lymph fluid that's not moving.

[00:18:55] Jean LaMantia, RD: And it can happen in the arm, it can happen in the face, the neck, the breast, the torso, the legs, anywhere in the body. And cancer is one reason. Other reasons might be, there's an injury. I've had people with, in car accidents, and their legs are injured with lymphedema in their legs. In tropical countries, there's a parasite that's inside mosquitoes, and you get bit by this mosquito, and then the parasite gets into your lymphatic system, so that's called filarial lymphedema.

[00:19:24] Jean LaMantia, RD: So there's all kinds of reasons, and estimated 10 million Americans have lymphedema. That's more than HIV ALS, MS Parkinson's, and Alzheimer's combined. And everyone's heard of all of those conditions. No one's heard of lymphedema. So that's what lymphedema is, it's chronic, there's no cure, there are, some surgeries that are now becoming more available, but really not accessible to nearly enough people.

[00:19:54] Jean LaMantia, RD: But otherwise it's chronic and you manage it. Lymphedema is a connective tissue disorder. It's also called a fat disorder. And it, this primarily affects women. Around puberty, women's bodies start to grow differently and it's because of a genetic inheritance. And their fat becomes fibrotic. So a woman who has lipedema might feel that, there's bumps in the fat or it could feel like grains of rice or peas or sometimes they're bigger, squishier lipomas.

[00:20:32] Jean LaMantia, RD: And it tends to happen on the hips. And the size. Now it can sometimes go all the way to the ankle. It can also affect the arm. In theory, it could affect the torso. It doesn't generally start there or affect it as much. So a woman who has lipedema might complain that, she's two sizes smaller on the top than on the bottom.

[00:20:55] Jean LaMantia, RD: Now a lot of women can have that. They're just that pear shape. 

[00:20:58] Jean LaMantia, RD: And they have a orange peel appearance to the skin. The skin, let's say on the stomach thick on the arms might look normal, but on the thighs, it looks bumpy. Now, this is often mistaken for cellulite, which leads to the misdiagnosis, which we'll talk about later. But the other interesting thing that women with lipedema will complain about is when they go to the airport and they're going to the scanner, they're often flagged for secondary.

[00:21:27] Jean LaMantia, RD: inspection where they have to get pat down and it's something about how that fibrotic fatty tissue appears as it goes through the scanner. Crazy. It's chronic, no cure, although there are specialized liposuction surgeries, but the reason they go together and the reason why you heard speak about them together at the FENCY conference is because the treatment is very similar.

[00:21:55] Jean LaMantia, RD: So the treatment is called complete decongestive therapy. And that has four main components, which is compression, skin care, manual lymphatic drainage, and exercise. And then there's of course diet stuff, which I know you want to ask me about, but I'll let you know. Go in order here. What's your questions?

[00:22:15] Christa Biegler, RD: For sure. Okay, so we heard about one thing I didn't grasp a hundred percent was with lymphedema There's an impact into the flow of the lymph fluid and there was a moment where you referred to right here And of course she meant as she said earlier right above the clavicle where that dumps in and then with lipidema You were describing it and I don't recall about why the lipidema It happens or if we know it happens, so can you just reiterate that if you didn't?

[00:22:42] Christa Biegler, RD: It happens. It's genetic. Interesting. You talked about this at the Girls would About old photos where the grandma would hide behind something, right? Of pipe legs. Exactly. 

[00:22:55] Jean LaMantia, RD: So when you inherit it, either from your mother's side or your father's side, so you have the predisposition, but the trigger is the hormone changes.

[00:23:07] Jean LaMantia, RD: And that's why it exerts itself or makes itself known at puberty in young girls, which is that's such a difficult time and then all of a sudden your body is developing very differently from your friends. Maybe you've got these big, bumpy looking hips and thighs and your legs don't look as slender as your friends and then starts on dieting and.

[00:23:31] Jean LaMantia, RD: Yeah it's just really devastating. And then if you think of the life cycle, then maybe a change in birth control might affect it. Maybe pregnancy will affect it. Maybe menopause will affect it. So any change in hormones can be a trigger there. So it's genetic, but hormonally activated, let's say. Sex hormones mostly?

[00:23:52] Jean LaMantia, RD: Yes. 

[00:23:53] Christa Biegler, RD: Yeah. Yeah. That would have to be the way you're talking about those hormonal changes. Sometimes we mention hormones. I think we, it's a big umbrella, so I didn't, it's to discern down the sex hormones, progesterone, estrogen, testosterone, especially. This is a challenge, especially if it's a young person, and one of the biggest challenges and one of the reasons we're having this conversation is that you said this with lymphedema, you talked about the prevalence is much higher than many conditions combined that we already are aware of.

[00:24:17] Christa Biegler, RD: How prevalent is lipedema? 

[00:24:20] Jean LaMantia, RD: Think of all the left handed people that you know. 

[00:24:23] Christa Biegler, RD: In. 

[00:24:24] Jean LaMantia, RD: So that's about 10 percent of the population is left handed. And of the women that you know, it's estimated that 10 to 11 percent have lipedema. So very prevalent, underdiagnosed, underrecognized. And the women who I meet who finally get a name for this thing that's going on with their body that has never made sense to them, that they've never been able to find an answer to, It's such a wave of different emotions.

[00:24:56] Jean LaMantia, RD: There's relief that, oh my gosh, I finally have a name for this thing. I knew there was something wrong with me. I knew I wasn't just lazy or overeating. Anger, like, why didn't my doctor? I've been complaining about this for 20 years and no one knew what it was. Sadness, because, oh, now I know what it is. But it's chronic.

[00:25:16] Jean LaMantia, RD: There's no pill to take. There's no easy way to deal with this. And I have to wear these compression holes for the rest of my life. So it's, I'm really sensitive to the women and all the emotions through, but unfortunately there's a lot of, what's the word, almost medical gaslighting that goes on.

[00:25:38] Jean LaMantia, RD: Oh, you're just eating too much. This is just obesity or this is just cellulite. You gotta move more. My one client. Who was very active as a kid, she rode horses, she was a figure skater, super active, but just her body just developed totally different from her other family members, and was put on diets by her mother, was sent to Weight Watchers by her mother, just The amount of almost medical trauma that she faced.

[00:26:08] Jean LaMantia, RD: She basically went on to social media and was looking at body positivity, following that hashtag, and then saw the words lymphedema and lipedema, which started her looking at it. And essentially she diagnosed herself. Like she did eventually find a doctor, give the official diagnosis, and get the right treatment.

[00:26:28] Jean LaMantia, RD: But so if women are listening to this and think, Hey, that sounds like me. Continue to do some research on your own and feel confident before you go to the family doc. They don't have a lot of training. It's not that they're trying to mislead you. They're just not taught about fat disorders or a lot of them even don't recognize lymphedema.

[00:26:53] Christa Biegler, RD: And if there's not a parent treatment that would be in their toolbox, then they would not get continuing education on it so commonly. Usually continuing education is going to follow the thing. It just depends, right? But it makes sense. So you talked about some characteristics. You talked about that it's this orange peel texture.

[00:27:12] Christa Biegler, RD: It's bumpy. You can get flagged for the secondary inspection at the airport. But as people start to discover this and realize, wow, this is one in 10 women, it's Are there diagnostic criteria women can go out and find? Who is the official source on the diagnostic criteria or even resources for these women?

[00:27:30] Christa Biegler, RD: So there's that question and then also a side question that goes with our conversation even before we go there. Is there, there are many conditions, many very common conditions that take, can take years to get a diagnosis. And we were talking about early, you don't need a diagnosis. So we'll go to that next, but how long does it take someone to get diagnosed?

[00:27:49] Christa Biegler, RD: So a while back, my college aged daughter shared with me that she was tossing and turning and waking up several times per night after a period of stress. We started her on magnesium and her sleep immediately improved. I personally think magnesium should be your first thing to try if you're having trouble sleeping or staying asleep, especially tossing and turning.

[00:28:09] Christa Biegler, RD: And it's a no brainer if you have any restless leg issues. The thing about magnesium is that there's a lot of types of magnesium that will give you symptomatic release, but I like to steer my clients and loved ones to a more absorbable form of magnesium. Because most big box magnesium is magcitrate, and that will push bowels that can be damaging to your teeth if it's used daily and it's not the most absorbable.

[00:28:33] Christa Biegler, RD: Rather, Jigsaw Health makes one of my favorite great tasting magnesium powders called MagSue that has magnesium glycinate, my favorite calming and absorbable type of magnesium. It's available in both a great tasting powder and to go packets and they also make a product that's great for slow release especially if you have restless legs called MagSRT.

[00:28:54] Christa Biegler, RD: If you are not falling asleep easily or if you have disrupted sleep, you can try at least 200 mg of great magnesium like MagSooth or MagSRT, especially if you have restless legs. It works better to take this at least 20 minutes before you go to bed to allow it to kick in. And you can get a discount on all of Jigsaw's amazing products, including MagSoothe at Jigsaw Health with the code LESSSTRESS10.

[00:29:19] Christa Biegler, RD: Now you can use LESSSTRESS10 as many times as you want with every order at Jigsaw Health, which is honestly pretty unheard of with coupon codes. So enjoy the magnesium from Jigsaw with my code LESSSTRESS10. Decades, usually. Yeah. So take matters A very long and frustrating journey, unfortunately. Yeah. So take, to shortcut that, taking matters into your own hands a bit and pulling that diagnostic criteria could be empowering in a place, in a pretty disempowering condition.

[00:29:50] Christa Biegler, RD: Where does one find the diagnostic criteria for Lipedema? There are some Lipedema organizations. There's a couple in the U. S. There's one now starting in Canada. So they have excellent resources. I've got some resources on my website as well. And people could look at that. I have things that you can print off and take to the doctor and so do the other national support organizations.

[00:30:15] Jean LaMantia, RD: So there are resources out there. Okay. Okay. So you talked about how there's the overlap primarily with lipidema and lymphedema is that the treatment, The four main treatments can be the generally recognized treatments are similar or the same, but what else, what are the other options that maybe are not as widely known or specifically, like, how are you as a dietician using diet and nutrition?

[00:30:40] Christa Biegler, RD: I'm curious how you, of course, you had your own limp experience as a young dietician, but I'm curious how this sort of unfolded for you also. So tell us a little bit about diet and nutrition with Lipoedema. So how it unfolded for me. It was after my own cancer treatment, I was approached to write a book, Cancer and Nutrition.

[00:31:03] Jean LaMantia, RD: And so that book is called the Essential Cancer Treatment Nutrition Guide and Cookbook. I also designed a teaching tool, I can show it here for the people who are watching rather than listening, it's called the Cancer Risk Reduction Guide and it talks about the different tools to use to. Reduce your cancer risk or like risk of recurrence.

[00:31:26] Jean LaMantia, RD: And so I had my name out there as a dietician who worked with cancer. And then I was approached by a certified lymphedema therapist to join her practice, which was dealing with lymphedema. And because most of her clientele had lymphedema because of cancer, she wanted a dietician who understood that. So when I got into that, I thought, Oh, okay.

[00:31:51] Jean LaMantia, RD: Let me just check the resources that are available from our national associations. There was a need for lymphedema. I'm like, that can't be right. So I just, thankfully, I'm a total nerd. So I just got onto PubMed and started researching them. I kept finding different things and started putting it together.

[00:32:10] Jean LaMantia, RD: And it was helping people. Their lymphedema was going down. They were getting good results. And I thought, okay, there's something here like nutrition really can make a difference. So then I started speaking at conferences and I approached my publisher and said, I think there's something here that we could do.

[00:32:28] Jean LaMantia, RD: So myself and the lymphoedema therapist who originally hired me said, yeah, let's put a book together. And it's been amazing. It's a bestseller. It's really helped a lot of people and been a resource for other dieticians, other lymphoedema therapists. As well as all the people that have lymphedema. So the book is focused around lymphedema.

[00:32:51] Christa Biegler, RD: And then people started probably coming to you for lipidema as well, I'm guessing. That's exactly right. So I got into lymphedema from cancer, and I got into lymphedema from lymphedema. And the way that works is, as the lymphedema gets worse, it can develop like a lymphedema type disease. presentation. So the lymphatic system starts to get involved.

[00:33:15] Jean LaMantia, RD: Now that's a little controversial because in Europe they don't feel that there's any lymphedema and lipedema, but the North American understanding is that, yeah, once you get to like stage 3 lipedema, you develop something called lipolymphedema. So then I would host my class called Lymphedema Nutrition School, and then women would join who had lipolymphedema.

[00:33:35] Jean LaMantia, RD: And then I'm like, okay, what is all this lipedema all about? And I got into that, and now I'm starting my first lipedema nutrition school to deal with some things that are a little distinct there compared to the lymphedema. Did you find when you were digging into the research then about lipedema, did you also find that the nutrition recommendations could overlap for both of them?

[00:33:55] Christa Biegler, RD: Yeah. Yeah. Yeah. The biggest overlap I would say is the anti inflammatory diet because they're both considered to be inflammatory conditions and we know from research in other areas that you can measure your blood levels of inflammation, and that you can lower that by changing your diet. So that's the big common denominator for my cancer survivors, for folks with lymphedema, for the ladies with lipedema, it's anti inflammatory diet.

[00:34:26] Jean LaMantia, RD: That's what unites everybody. 

[00:34:27] Christa Biegler, RD: If someone's listening to this and they feel, I think, gene just, told me about myself and no one else has ever recognized one of these conditions. I think also before we even go to some of those thoughts, I'll mention that I heard you say at the conference, I think both of these conditions have a lot of emotional challenges and it seems that sometimes I'm not sure with lymphedema specifically, it can be life altering.

[00:34:51] Christa Biegler, RD: You mentioned yourself, even when you went in for your cancer, you could barely kind of maybe move your arms, right? And if you have this lymph buildup, it is very challenging and perhaps quite miserable. And so I think I remember a story where you said, someone had said, I would rather have cancer again than have this condition.

[00:35:09] Christa Biegler, RD: Right? 

[00:35:09] Jean LaMantia, RD: Yeah. And It's devastating. 

[00:35:13] Christa Biegler, RD: Do you think that lymphedema is more recognized than lipedema, or do you think that they're equally misunderstood and under recognized? 

[00:35:21] Jean LaMantia, RD: I would say lymphedema is more recognized. 

[00:35:25] Christa Biegler, RD: That would make more sense. 

[00:35:26] Jean LaMantia, RD: Part of that is I think the cancer community who's come to see lymphedema as a side effect of cancer treatment and they see these women coming back for their follow ups and arms are swollen or their legs are swollen and they're recognizing, Hey, this is lymphedema.

[00:35:42] Jean LaMantia, RD: Let's get them to see a certified lymphedema therapist and it's men and women, right? Whereas lymphedema, because it's women and it tends to occur in women who Also, may have a comorbidity of living in a larger body, which some in the medical profession would call obesity. There can be a lot of that, no, you're just overweight, no, it's, you just have to eat less, or this is just cellulite, or there's still a lot of, it's an uphill battle to get the proper diagnosis.

[00:36:17] Jean LaMantia, RD: And on the flip side of that are maybe women who don't have lipedema, who just have that pear shaped body presentation, and maybe they have cellulite. Now finding out about lipedema, going to the doctor and saying they have it. There's both, and as the awareness increases, I think doctors are left with not a lot of experience.

[00:36:39] Jean LaMantia, RD: It's still trying to sort out who legitimately has this. And who does it? Even though from the outward appearance, they can look very similar. 

[00:36:47] Christa Biegler, RD: Yeah. One cool thing is that sometimes for different conditions, there is a lot of, you can find literature about it, but someone has to be there to synthesize it and put it together, which is where you found yourself accidentally.

[00:36:59] Christa Biegler, RD: Aside from the anti inflammatory diet, which is the common denominator for both of these conditions, there's the role of protein is important. At least one of them, right? Is that lymph, lymphedema? And why specifically is that? 

[00:37:11] Jean LaMantia, RD: Unlike the cardiovascular system, you got the heart to pump the blood. And with lymphedema, you don't have one central pumps that lymph fluid.

[00:37:23] Jean LaMantia, RD: You have little lymph angions, like tiny little pumps. And what activates those lymphageons is the muscle and moving your muscle. And if you are declining in muscle, as we do after our 20s, the muscle mass starts to go down and then there's a big loss through menopause or andropause. You don't get that same muscle pumping.

[00:37:51] Jean LaMantia, RD: And so one way to slow down that muscle loss is to make sure you're getting enough protein to meet your needs. So that's the real connection there with the protein and the lymphedema. 

[00:38:02] Christa Biegler, RD: So if someone's listening to this and they feel like gene just diagnosed helped me see a new light in my life or maybe this is something that affects me or even different, what is the message that you would want to share with people listening to this about lymphedema or lipidema?

[00:38:18] Jean LaMantia, RD: I think if you suspect that you have it, you need to get into action mode. and find somebody to help you. With lymphedema, for sure, it's a progressive disease. With lipedema, again, there's this European versus North American thought. The Europeans will say, it doesn't progress. As long as you don't gain weight, it won't progress.

[00:38:39] Jean LaMantia, RD: Whereas, the North American thought is, yeah, it's progressive. But either way, you want to find someone to help you. Now, first step most people might think of is, I gotta get this diagnosed and head straight to the family doctor. That's not bad strategy, but if you're not getting anywhere with that or you're just getting frustrated with that, what I would suggest is head to the certifiable lymphoedema therapist.

[00:39:08] Jean LaMantia, RD: Now, this is a health professional that could be physiotherapist, anesthesiologist, an occupational therapist, any of those body manipulation type professions. That's the prerequisite. So you have to be one of those health professionals. And then you get additional training, hands on training to become a certified lymphedema therapist.

[00:39:31] Jean LaMantia, RD: And they're the ones who are really trained to work with lymphedema and lipidema. And you find one of them, and you go to them, and even if they can't diagnose you, maybe that's not within their scope of practice, they could say, Yeah, I think this is looking a lot like lymphedema or lipedema, and they can say, In your area, here are the doctors that I know how to diagnose this, because they're the ones who are referring their patients to me.

[00:39:56] Jean LaMantia, RD: And that would be a good place to start, because maybe they can say, there's a vascular surgeon, And this person definitely knows lymphedema, lipedema. You need to get a referral to them. And they can help you rather than you thinking, I have to have the diagnosis, I have to find the doctor that can recognize this and diagnose me.

[00:40:16] Jean LaMantia, RD: I would suggest a good shortcut is go directly to the certified lymphedema therapist. Jean, where can people find you online? Yeah. So I'm on my website, which is my name, Jean, J E A N, L A M E N T E A, L A T E A, M A N T I A dot com. 

[00:40:37] Christa Biegler, RD: And there's information for all of these conditions, right? Lymphedema.

[00:40:41] Christa Biegler, RD: Inclusion. 

[00:40:42] Jean LaMantia, RD: Yeah. I nerd out on that blog that I've got going. And here is something I will suggest just in general. If you're ever looking for health and medical information online, you're going to a blog. If they're not referencing their sources, red flag, all right? I definitely reference everything, I've got piles of information there, lots of topics related to lymphedema, including how it's diagnosed, how it's treated, same with lipedema, and I even have one on resources, so if you go on to the lymphedema resources blog, you'll see links to the different organizations and training schools that have directories to help you find a certified lymphedema therapist in your area.

[00:41:26] Jean LaMantia, RD: Now, because I work virtually, you don't have to live around the corner from me. We can work together one on one virtually, or you can join one of my classes from anywhere in the world. I've had people from New Zealand join, and Australia, and England, and Mexico. So there's no limit to who can 

[00:41:45] Christa Biegler, RD: join the online classes.

[00:41:47] Christa Biegler, RD: Amazing. Thank you so much for coming on today and sharing so much about your personal story, which is quite dramatic, and how your journey has evolved. Really meandered around to be helping all of these populations that need support and resources and offering that out to the world. Thank you. 

[00:42:05] Jean LaMantia, RD: Thank you for highlighting this and hopefully there's someone that's listening that can be helped by you sharing this information and getting it out there.

[00:42:12] Jean LaMantia, RD: We can only hope so. For what you do.