Payton Olthoff, RCH’s Occupational Therapy Assistant and the new certified lymphedema specialist on the campus.

Rim Country Health & Rehabilitation is pleased to share that a new Certified Lymphedema Specialist is on board and scheduling outpatient appointments.

In 2019, RCH was excited to bring on a certified lymphedema specialist. Many community members were thrilled they no longer had to drive to the Valley. But, due to the restrictions placed on campuses similar to RCH, outpatient rehab therapy was not authorized to be open. But now you can schedule lymphedema therapies here at RCH!

Meet Payton Olthoff, RCH’s Occupational Therapy Assistant (OTA) and now… the new certified lymphedema specialist on the campus.

Payton joined RCH in 2020 to fill a position in RCHs rehab therapy department in occupational therapy. She began her career – with the goal of becoming a nurse, first as a certified nursing assistant (CNA). This allowed her to accompany nurses to patient visits. Payton said, “I always knew assisting people through recovery was what I wanted to do. After spending time in the field, I realized that rehab therapy, and one-on-one interactions, produced positive impacts in patients’ recoveries. That’s when I switched to rehab therapy.”

So why lymphedema therapy? Payton shared that she recognized the need for lymphedema therapy in rural areas.

“Many times patients are not diagnosed, or are misdiagnosed, and they just settle for living with the swelling. When they don’t have to,” stated Payton.

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.

You, or someone you know, may wear compression stockings or sleeves (legs or arms). It’s commonplace now. And, then there are many people who experience swelling in the arms or legs that decide to just live with it.

Many times treatment is not sought because physicians and patients are unaware of the possible therapies.

Rim Country Health & Rehabilitation knows that lymphedema therapy is needed in Rim Country. 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.

Reducing swelling helps with regaining movement. Getting on the road to recovery.

Local cardiologists and certified venous and lymphatic treatment physicians stated this when RCH first began this specialty, “Payson residents are so lucky that a lymphedema therapist will be available locally to assist with the therapy.” “Anyone with an established diagnosis of lymphedema or with unexplained leg swelling should be encouraged to seek out the certified therapist’s help.”

Lynne Krahn, and RCH administrator Tabitha Meyer, were pleased when Payton shared that she was interested and enrolled in certifications classes, this year, and became certified.

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

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% 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 for each 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 is 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. For information on lymphedema therapies, call RCH director of rehab therapy, Lynne Krahn, 928-474-1120.

Health. Care. Living!

August 14 is the Women’s Wellness Forum. Stop by the RCH table to meet Payton Olthoff (RCH) and Jeff Powl from Juzo Compression Garments. Get your questions answered and measured, correctly, about/for compression garments.

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