qustions on the use of lymphedemia pump

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qustions on the use of lymphedemia pump

Postby burnedoutmom » Sat Jun 19, 2010 12:53 pm

I have been seeing a therapist for the last 2 weeks and learning how to bandage my leg. However, I have also learned that the doctor and the therapist do not see eye to eye about the treatmemt. I have beencaught in hte middle of the spirited disagreeement with both of them telling me different points of view. WHo does one listen to? Has anyone else had this problem? Has anyone else been told by a therapist to stop using the pump because it is bad for lymphedemia??

Jackie :oops: :oops:
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Re: qustions on the use of lymphedemia pump

Postby Cassie » Sat Jun 19, 2010 6:48 pm

Wow, Jackie, what a crummy position you're in! You must be about ready to knock a couple of heads together!

Pumps are controversial, Jackie. They're definitely not a part of standard lymphedema treatment, though some brands can be useful as a help ALONG WITH all the standard care. The standard is called Complete Decongestive Therapy, or CDT. It consists of Manual Lymph Drainage massage (MLD), compression, specific exercise, and very careful skin care.

Manual Lymph Drainage is done for a period of a few weeks by a well-trained lymphedema therapist (as you apparently have). S/he should also be teaching you to do a version of manual lymph drainage yourself, so that when you're done with the intensive therapy phase you can manage on your own.

Compression involves wrapping during the few weeks of CDT and usually also at night afterwards, so you should be learning to wrap your leg yourself as well. Once therapy is over, you're fitted for appropriate compression garments to wear during the day.

Your therapist will also instruct you in how to exercise when you're wrapped, and how to care for your skin.

Once initial therapy is complete and you're doing your own self-MLD and self night wrapping, some people opt to use a pump in place of PART of their at-home self-MLD. But it does matter what kind of pump you use. Currently, Flexitouch is the one least likely to cause problems. Pumps really can be very bad for lymphedema, because they "wring" out the lymph fluid without moving it into functioning nodes to be returned to the circulatory system. When this happens the fluid builds up at the top of the leg and can lead to genital or abdominal lymphedema. So I sure do understand what your therapist is saying about this.

Just my humble opinion, of course, but if your therapist has been well trained (at least 135 hours of specifically lymphedema training beyond his/her PT or OT certification and a year or more of experience treating lymphedema), then s/he is the professional to trust in this matter. Dr. Stanley Rockson at Stanford conducted a survey of U.S. med schools and found doctor training in the lymph system seriously lacking (would you believe an average of 15 minutes training in the entire 4-year training program?) Even those with more than 15 minutes training sure can't equal the 135 hours of specific training of a good lymphedema therapist.

How is the therapy going for you? If you find it working to reduce swelling and help you gain control, then I think you can trust your therapist to give you the kind of advice you need to get on top of this and stay that way.

Kinda crazy, isn't it?! :roll:
Let us know how this works out for you!
Cassie
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Re: qustions on the use of lymphedemia pump

Postby Queenie EJC » Mon Jun 21, 2010 7:58 am

I agree with Cassie that Flexitouch is the pump of choice, mimicing lymphatic massage. I have used others in the past over 24 years of dealing with lymphedema, beginning with the old Jobst pump without any progressive "milking" of the lymphatic fluid, on to the progressive chambers type, and finally the Flexitouch which has proved to be the most effective without problems at all for me over the past couple years. Prior to this, I've had many cellulitis flare-ups. I also believe that indiscriminate pushing of the fluids upward into the pelvis can cause pelvic edema as well. I have this problem which I attribute largely to the older type pumps.
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