Lincoln Lymphedema Clinic
So much of what I do as a therapist is not well understood as public knowledge, so I get a lot of questions. First, what is an occupational therapist? Well, it is not a career services professional. An occupational therapist is a holistic health professional who works to help people live their best lives with an emphasis on self-care, independence, and dignity. Second, what is a certified lymphedema therapist? A certified lymphedema therapist is someone who has successfully completed a 135-hour training course to learn to treat lymphedema.
In the past five years, I have noticed a lot of people living with lymphedema that goes untreated because the awareness is simply lacking. I have also noticed the great impact that good treatment can yield, and a lack of certified therapists. My choice to seek certification was largely driven by the identification of an unmet need in our community. Here, I want to answer some of the most common questions about lymphedema, causes, diagnosis, and treatment.
What is lymphedema? – Lymphedema is a specific type of swelling that happens when a protein-rich, clear fluid, called lymph builds up in your tissue causing it to swell.
What causes lymphedema? – In short, a problem with the lymphatic system. Some people are born with developmental issues such that their lymphatic systems are either underdeveloped or extremely overdeveloped and not working well enough. Other people are born with lymphatic systems that are functional but can just barely handle the daily load. Then something happens to tip the balance, and the lymphatic system can no longer keep up with the demand. The most common cause in the United States is cancer treatments, with the leader being breast cancer treatment. This can be caused when lymph nodes are removed or radiation treatments damage the lymph nodes and lead to secondary lymphedema.
How do you know if your swelling is lymphedema or another type of edema? – I believe with any type of swelling there is always going to be a lymphatic component. Most health care professionals diagnose lymphedema with a review of your medical history and a physical exam. There are several diagnostic procedures used to examine the lymphatic system and diagnose lymphedema, however, the results typically do not change the treatment process, the tests add costs to your care and require your time and participation.
How do you treat lymphedema, what can I expect? – The gold standard for lymphedema treatment is called complete decongestive therapy (CDT). With CDT you treat lymphedema with manual lymphatic drainage (MLD) techniques, compression, skincare, and remedial exercises during the intensive treatment phase. During the second treatment phase, you would focus on transitioning to long-term management, or what is commonly called the maintenance phase. During phase two you learn to perform skin cares, home exercises, self-MLD techniques, apply and remove daily wear compression.
How long does the treatment take? – That varies greatly depending on the severity of the symptoms. It can take anywhere from a few visits to weeks of ongoing treatment. A more informed estimate could be discussed during an evaluation with a certified lymphedema therapist. Naturally, as treatment progresses you and your therapist will more accurately be able to predict what is needed to reach your goals.
Who should I see to treat lymphedema? – I would recommend getting lymphedema treatment from a certified lymphedema therapist (CLT). Many health care professionals are qualified to become certified including physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, speech therapists, and massage therapists. Additionally, the therapist can demonstrate knowledge of lymphatic conditions, treatment, and related issues by passing the Lymphology Association of North America (LANA) board exam and carrying the CLT-LANA credentials behind their name.