marketing & community liaison rim country health
What is lymphedema? And, how can you get therapy right here in Payson?
Lymphedema may be a result of treatment from cancer care, vein or lymphatic disorders, stroke, infections, multiple sclerosis, melanoma or other conditions that damage or block the lymphatic nodes or system and fluid accumulates beneath the skin creating swelling.
First of all, there are many people who experience swelling in the arms or legs but decide to just live with it. You, or someone you know, may wear compression stockings or sleeves (legs or arms).
And, many times treatment is not sought because physicians and patients are unaware of the possible therapies.
Rim Country Health & Rehabilitation is proud to announce that the RCH Rehab Therapy department now offers Lymphedema Therapy. Lynne Krahn, director of rehabilitation therapy for RCH shares, “A constant evaluation of the department, along with meetings with community health care alliances, begs for considering the treatments needed in Rim Country.” Lynne stressed, she thinks about RCH residents and outpatients, but also about the community.
Carolyn Lohmann, nurse practitioner for Dr. Alan Michels, RCH medical director, said, “It’s challenging to find therapy for lymphedema in the Rim Country area. Now we have someone.” Carolyn noted that reducing swelling would help with regaining movement. Getting on the road to recovery.
Dr. Mir Ali, local cardiologist and certified venous and lymphatic treatment physician said, “Payson residents are so lucky that a lymphedema therapist will be available locally to assist with the therapy. I encourage anyone with an established diagnosis of lymphedema or with unexplained leg swelling to seek out the certified therapist’s help.”
Hiring decisions are not made overnight, but when the opportunity presents itself, it’s worth consideration. A recent search was conducted to add an occupational therapist to the team. An occupational therapist, with a certification in lymphedema therapy, was interested in moving to Payson and RCH. Lynne and RCH administrator Tabitha Meyer extended an invitation to visit over the April 27 weekend, when the Women’s Wellness Forum was held, to get a feel for the RCH rehab therapy department and the community. The invitation was accepted.
Beginning in mid-June, Jane Oliver, occupational therapist, and certified lymphedema therapist, joined the RCH therapy team.
I sat down to talk with Jane to gather more information on how Rim Country area residents can understand more about lymphedema.
“As an OT (occupational therapist), I’m educating patients about their condition, treatment options and attaining their goals. I think of treating lymphedema with the same approaches for success,” said Oliver.
She strongly encourages a caregiver (family member, friend, aide) attend during the first week (five days) of treatment in order to experience the same education, training and see the results of drainage in preparation for when the treatment is completed (and home therapy begins).
The good news is once a patient completes the treatment plan, many patients successfully continue with a home therapy plan, which is self-administered. This is another way for retaining control and independence at home.
Sample Treatment Plan
Week One: Evaluation and education then schedule weekly therapy, for five consecutive days (each week begins on a Monday). Each session is approximately 50 minutes.
The specific needs of the patient will determine the plan for Weeks Two through Four — such as how many days treatment is needed each week, results of measurements of swelling reduction, drainage outcomes and more.
Manual Lymph Drainage
Treatment may include manual lymph drainage with light touch massage to free the blockage and/or open an alternate route. Example: In breast cancer care, arm edema is from removed lymph nodes affected under the arm in radiation. The lymphatic system is superficial and does not involve deep massage. And, cervical nodes that are up and over can be reached to alleviate swelling.
Compression Wrapping is a multi-layer technique that can be safely worn both day and night. This is due to the low resting pressure exerted when the muscles are inactive and relaxed. Bandaging is effective during exercise because it provides additional resistance.
Hygiene and Compression Wrapping Layers:
1. Skin Care — Prevent infections by gently washing with a PH balance cleanser closest to the PH of your skin. Apply lotion after washing and patting dry.
2. Stockinette — After moisturizing, stockinette is typically the first layer of bandaging. It is very soft, skin friendly, and acts as a protective layer for the skin.
3. Cotton Padding — Placed over the stockinette, followed by multiple overlapping layers of short-stretch bandages. Short-stretch bandages look like the Ace bandages you might get at the drugstore, but they’re much less stretchy.
4. Short Stretch Compression Bandages — Short-stretch fabrics are designed to extend no more than approximately 60 percent of their original length when stretched. Short-stretch bandages provide the kind of permanent, working pressure needed to encourage lymphatic drainage, even when you are at rest.
5. Spandex Wear – The last layer holds it all together. Compression garments encourage the flow of lymph fluid out of the affected area and back into the body’s lymphatic system.
Move. Move. Move. Therapists are all in agreement that movement aids in healing. Depending on the specific condition, an exercise routine will be determined and will be different by person and stage of therapy.
The end goal is to have the patient advance to the Maintenance Mode. Self-administered, home care (with a family member, caregiver, aide) utilizing a compression garment and exercise.
Follow up appointments are then reduced to once week, then to once a month, and then biannual check-ups.
Lymphedema therapy will be available on an outpatient basis at RCH. Ask your physician to write an order (or prescription) for OT/PT evaluation and treatment. Bring that with you when you bring your health insurance card in for verification and approval. The next step is scheduling your evaluation.
Outpatient health insurances accepted may include Medicare A, an indemnity insurance or private pay.
My thanks to Lynne and Jane for sharing their knowledge and time to best explain lymphedema therapy.
RCH will schedule a Lymphedema Therapy Educational Seminar for the community in August in the community room (date to be announced). RCH has already been scheduled to speak about Lymphedema Therapy at a Banner High Country Seniors luncheon on November 6.
If more immediate information on lymphedema therapy is needed, please call RCH director of rehab therapy, Lynne Krahn at 928-474-1120.