by Jason P. Smith
Lori Brown, OTR, CHT at St. Anthony Central Hospital, recently was certified in something that could help people who have something they thought or were told nothing could be done to help.
During this year’s breast cancer awareness month, there is some positive news for women suffering from lymphedema in the Denver area.
St. Anthony Central Hospital Outpatient Physical Rehabilitation Department recently expanded its services to include comprehensive Lymphedema and Venous Edema Management. A chronic swelling of an extremity or part of the body caused by a deficiency in the flow of lymph fluid from the area, lymphedema is something that has gone without effective treatment for years.
Lymphedema is something that can be due to surgical removal of the lymph nodes, congenital, having too few or impaired lymph nodes or destruction of extensive lymphatic pathways due to trauma, surgery or radiation.
Breast and prostate cancer patients are most likely to incur this condition, and until more recently, many were told there is no effective treatment.
Brown, who has practiced at St. Anthony Hospitals for the last 13 years, was aware of this comprehensive treatment possibility, but was also aware that there were very few practitioners in the Denver area and almost none who accepted Medicare and Medicaid.
Determined to make a difference, Lori became certified in this treatment modality, which includes European methods of manual lymphatic drainage, exercise and medical compression bandaging. She has been seeing patients at St. Anthony Central Hospital for lymphadema treatment since January of this year, and is projecting to expand to St. Anthony North Hospital if the demand is there.
Brown took the 80-hour course last November and has been seeing patients ever since.
"The training in the course helps you learn specialized general massage, medical bandaging techniques and home exercise programs and education that goes along with it – the treatment of the patients is those three things," Brown said. "Also, it’s getting them on a program that they can then continue usually lifelong.
"The most common patients I’m seeing right now are women who are post mastectomy patients who have had breast cancer. Months or sometimes many years down the road, they will develop a swelling in their arm, which is lymphedema."
Brown said she currently is working with a patient who has had lymphedema his entire life, but just recently underwent surgery on his knee and was told by his doctor to seek treatment.
"He’s very active, but his legs are very swollen," Brown said. "He’s been coming in for treatment and he said his legs have never been so small – it’s remarkable to see the treatment work.
"This is a specialized treatment that you need to be certified to do, and it’s very hard to find in Denver.," Brown said. "There are some other therapists who do it, but what was happening here was we would get a lot of patients who were referred and we’d have to tell them we don’t do that here. So, I started making phone calls to different hospitals and asking who does it, but it’s very difficult to find."
According to Brown, there is a high demand for it, but it’s hard to find therapists who will provide it.
"Many patients I’ve seen will tell me their doctors told them they just have to live with it, so we’re trying to get the word out that that’s not the case.," she said.
Although Brown wants to get the word out to doctors and patients, she said getting the word out to nurses that a new treatment is available is maybe the most important audience she can reach.
"Many times it’s the nurses who catch this down the road because the patients are not going to go back and see their oncologist or their surgeon," she said. "Lots of times it’s the nurses who can really red flag this and tell their patients they don’t have to live with this and that there are some treatments out there they can do."
In very simple terms, Brown explained that the idea of the treatment is to start with the patent’s core and work the swelling out and then back in, coupled with different breathing and exercise techniques. Then, once it’s moved out, you use bandages.
"Once you have it well managed, which can take up to six months to a year, they can be fitted with sleeves to help keep it under control," she said.
The most common American treatments until recently were diuretics, exercise, then pneumatic compression pump, a message or just go home and live with it.
"Some did benefit from those treatments, but generally it did not work," Brown said.
"The goal is to get people into a self-management program," she continued. "It really empowers people. Especially people who have had cancer, because those patients in that population generally don’t have a lot of control over what happens to them, so to be able to empower them is a really positive step for them."