Lymphedema

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Lymphedema patients doing yoga

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

For a long time, it was debated whether patients with lymphedema should partake in an exercise regimen. Today, fears of overloading the lymphatic system and of causing injuries have been resolved by research findings; however, there are precautions to take, and some types of exercise are more beneficial than others. When done correctly, these exercises can improve strength, quality of life, and ability to care for oneself and others, increase range of motion, decrease pain, and even reduce edema. Lymphedema-specific programs have been developed by wonderfully creative and knowledgeable people, too. As always, patients must consult with a health care provider before embarking on a new exercise regimen. If you are managing a patient who lacks strength or full range of motion, has difficulty in daily activities, or has problems walking, therapists can help develop a safe program and improve deficits to work up to a recreational exercise program.

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Lymphatic System

by Janet Wolfson PT, CLWT, CS, CLT-LANA

Manual lymphatic drainage (MLD) was developed by Emil and Estrid Vodder in the 1930s. They dedicated their lives to the study of lymphatic anatomy and physiology. Since then, others have modified the original techniques, including Foeldi, Leduc, Casley-Smith, and Bjork. They all involve manual contact with the client, deep diaphragmatic breathing, stimulation of the lymph nodes, and movement of fluid from proximal and then distal areas. The manual contacts are slow, gentle, and rhythmic. Practitioners are typically occupational or physical therapists, physical and occupational therapy assistants, nurses, massage therapists, and physicians. Many practitioners, after a required 135-hour training program, complete the Lymphedema Association of North America (LANA) certification exam.

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lymphedema management and prevention

By Janet Wolfson PT, CLWT, CS, CLT-LANA

With increased awareness of the impact of the lymphatic system on all other systems of the body, there are now multitudes of research studies on lymphedema and thus new approaches and treatments by the medical profession. These include medications, prevention, detection, surgery, and regeneration. Despite cursory education on the lymphatics in medical school, research in the United States and elsewhere has managed to progress treatment.

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post-surgical cancer patient

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

So, if you are following my series on the lymphatic system, then recall that last month the topic was causes of lymphedema. Today I will dive into how modern medical care and disease processes can affect the lymphatic system.

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lymphedema and the lymphatic system

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

If you had a chance to read last month's blog on the lymphedema and the lymphatic system, you're probably still amazed that such a wonderful system that provides immunity and handles fluid in our bodies exists in such secrecy. This blog discusses what can go wrong with the lymphatic system. Because this network has many parts throughout the body, with cells that generated and living in different areas, whose complexity needs consideration with other disease processes or surgery, and must be constructed in 9 months of gestation... A lot could go wrong!

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the lymphatic system

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

When I talk to my patients with lymphedema, I often need to tell them about their lymphatic system. Beyond knowing of lymph nodes or glands in their neck, most don't recall having heard anything about it. Surprisingly, today's medical students often have less than one hour on the lymphatic system education in medical school.

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compression therapy for lymphedema

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

The intersection of wounds and lymphedema has been on my mind this week as challenging patients and a new reduction garment cross my dual specialty life.

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new research in the field of lymphedema management

by Janet Wolfson, PT, CLWT, CWS, CLT-LANA

At the beginning of September, I attended the National Lymphedema Network International Conference in Dallas, TX. As with most conferences it was chock-full of new research, meet-ups with former colleagues, vendors with wonderful new and upgraded products, and clinical topics to improve direct care. Continue reading for some highlights that can improve care in your wound clinic for venous disease patients, as well as lymphedema and lipedema patients. Preoperative awareness of lymphedema was also highlighted at the conference.

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total knee replacement surgical wound healing

by Janet Wolfson, PT, CLWT, CWS, CLT-LANA

If you read my last blog on therapeutic interventions to stimulate wound healing, then you may recall the asset that a lymphedema trained therapist can be to your wound care department. A recent patient at the inpatient rehab facility where I am currently the Wound Care Coordinator illustrates this wonderfully.

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electrical stimulation therapy in wound healing

by Janet Wolfson, PT, CLWT, CWS, CLT-LANA

I know we have all had those patients with diagnoses that impair their wounds forming granulation tissue to fill wound depth. Perhaps there are comorbidities such as diabetes, peripheral artery disease or malnutrition. Skin flaps, cellular and/or tissue-based products for wounds, and hyperbaric oxygen therapy are alternatives, but not every patient can tolerate surgery or a hyperbaric chamber, has a shallow enough wound or enough arterial supply to make these other options successful.

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