Understanding Lymphedema Therapy
By Peter Hodges
Till today, there is no cure for lymphedema, so the only way to manage and control the condition is to follow the standard lymphedema therapy. The Complete Decongestive Therapy or CDT is the best tool for managing the condition. The therapy involves manual lymph drainage (MLD) which is the main aspect, and also includes the application of compression bandages, use of compression garments, regular exercise and a special skin care regimen that the patient must strictly follow. The MLD technique was developed by Emil Vodder in 1930 and is seen to be the standard method of lymphedema treatment although many other methods are also prevalent.
For the therapy, the patient has to make almost daily visits to a trained lymphedema therapist who performs the special lymphatic massage. In this massage, the lymphatic ducts are manipulated around the clogged areas to drain the extra fluids that have stagnated. The fluids are moved towards the venous system and passed on to the blood stream for elimination. This is not like a usual massage but is a relaxing procedure where rhythmic strokes are applied to encourage the lymph flow. The massage is started at the neck area, followed by the trunk and lastly the affected body part. The aim is to clear the pathways for the extra fluids that will be passed on from the swollen extremity to the trunk area.
Many centers offer lymphedema therapy, staffed by trained professional therapists who perform the lymphatic massage. It is preferable to visit a LANA certified therapist because they are extremely competent and you are assured of positive results. Large hospitals also offer the facility. The patients should not travel long distances for the therapy, so it is preferable to find a lymphedema center closer to home. When you visit the center, the therapist will evaluate your medical history, the range of motion as well as the integrity of skin. Measurements will be taken of the affected part and taking all the factors into account, a treatment plan, suitable for the individual will be created.
The lymphedema treatment plan usually includes a manual lymph drainage session 4-5 days a week and compression bandaging between sessions to sustain the reduction of the limb. A sequential gradient pump may be used by some therapists to help break up fibrotic tissues. The treatment plans always include patient education to enable the patient to manage the condition at home. Guidance is provided in skin care measures along with instructions for exercises and general precautionary measures to be taken.
The training courses for the therapy are open for doctors, physical therapists as well as nursing professionals. Hands-on, practical training is provided in the two-week course. The main focus is on the manual lymphatic massage as well as the compression bandaging technique. Instructions are provided regarding the special exercises and skin care for lymphedema patients. If you wish to take up lymphedema therapy, you must have a complete understanding of the anatomy, the physiology and the working of the lymphatic system.
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