San Antonio defense lawyer lobbies for Medicare to cover treatment for ‘side effect’ of cancer care


A San Antonio-based criminal defense lawyer who built her greater than 30-year profession defending wrongfully convicted people is now taking over the nation’s medical insurance system.

In April, Cynthia Orr lobbied Congress in support of the lymphedema Treatment Act. The bill is on the U.S. House and Senate floors — labeled HB 3630 and SB 1315 — and gaining bipartisan support amongst lawmakers.

If passed, the laws would have Medicare pay for compression garments used to forestall and treat lymphedema — a painful condition that affects 1 in 1,000 cancer patients. Individuals with the condition experience severe swelling and may profit from such treatment.

Orr considers herself a “skilled problem-solver,” so when she learned that cancer survivors were needlessly suffering because they couldn’t afford prescribed compression garments, she took up the cause pro bono. She understands what individuals with lymphedema undergo and why they need this treatment because she is certainly one of them.

The high-profile lawyer recently secured backing from the San Antonio Bar Association and says she won’t stop until compression treatment is roofed by Medicare and Medicaid. Then, she reasons, it could only be a matter of time before private insurance firms approve the doctor-prescribed treatment for his or her beneficiaries.

lymphedema is attributable to a build-up of fluid that happens when the lymphatic system is faulty or damaged. The condition may end up from an injury or from having one’s lymph nodes removed as a part of certain cancer treatments, which was the case for Orr.

She was diagnosed with breast cancer in 2013, and despite having to travel recurrently to MD Anderson in Houston for treatment, she largely kept her condition secret. She tried and won a federal terrorism case while undergoing chemotherapy.

Orr remembers a nurse explaining that her life-saving surgery made her more prone to developing lymphedema, describing it as a “side effect,” but through the years, cancer became a distant memory.

That was until November 2020, when Orr nicked her left hand while cutting vegetables for dinner. In lower than 24 hours, it swelled to greater than twice its normal size. She knew immediately what was happening to her.

“They need to call it something more serious than a side effect,” she said during an interview in her law office on the penthouse floor of the Tower Life constructing in downtown San Antonio.

Orr is accustomed to fighting for people getting a raw deal from the criminal justice system.

Orr was a part of the legal team that argued for the discharge of Michael Morton, an innocent man who was convicted in 1987 for the murder of his wife in Williamson County.

She also helped Hannah Overton of Corpus Christi get her conviction overturned and secure her released after spending seven years behind bars. She was accused of the salt-poisoning death of her 4-year-old son. A poster for a 2016 documentary based on the case hangs in Orr’s office.

Orr recently demonstrated how she wraps her left arm up with custom compression garments several times a day. The treatment is tedious, extending from the underside of her fingers to her shoulder, but it surely’s mandatory to attenuate the painful swelling and avoid the chance of more severe disability.

Dr. Brian Fricke, director of the Cancer Rehabilitation division at UT Health San Antonio’s MD Anderson Mays Cancer Center and the one such specialist in South Texas, is treating Orr.

She was at high risk of developing lymphedema in consequence of getting nearly all of the lymph nodes in her armpit removed during her cancer treatment, Fricke said.

“Then she had radiation treatment, as well, which further caused scarring and narrowing of the caliber of the lymphatic vessels that remained in her arm,” he said. “So when she cut her hand, that was form of just like the straw that broke the camel’s back.”

Fricke said that while most individuals can fend off a minor infection from a cut with Neosporin, in Orr’s case, it activated her lymphatic system to mount an immune response, which wasn’t in a position to mobilize properly.

The swelling in her left arm has since subsided with intensive decongestive therapy, though not as quickly as she hoped.

She was referred to Dr. Anton Fries, a reconstructive microsurgeon at UT Health San Antonio, who performed a fragile surgery to transplant lymph nodes from Orr’s stomach, removed laparoscopically, to her arm.

Orr appreciates that she’s fortunate to have the opportunity to afford and receive the medical care she needs. Many lymphedema patients go without compression treatment or are forced to ration their wraps, bandages and garments because medical insurance corporations don’t cover them.

And for individuals with more advanced or more severe lymphedema, particularly those with lower extremity lymphedema, Fricke said, “something so simple as like a hangnail or ingrown fingernail or toenail” can turn into serious.

Historically, Fricke said, Medicare, Medicaid and personal insurers have considered lymphedema to be a cosmetic problem.

“That is thus far from the reality,” he said.

Yet pneumatic compression pumps, devices that cost Medicare $4,000 to $6,000, are covered. Meanwhile, Medicare pays when lymphedema patients find yourself in intensive care units or on intravenous antibiotics.

“It costs your entire health care system an entire lot of cash for saving, you realize, relative pennies on compression garments,” Fricke said.


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