Lymphedema & MLD
Lymphedema care with Laura Dear, RMT
What is lymphedema? It is swelling of the soft tissue caused by a mechanical insufficiency of the lymphatic system, that is, the system is damaged and unable to absorb the normal lymphatic load. (Vodder)
There is Primary and Secondary lymphedema. Primary has no known cause, the person is born with it and it may present at infancy, puberty, pregnancy or menopause. There are many syndromes as well that are associated with Primary LE. Secondary LE has a known cause, we would see swelling often after lymph node removal for cancer surgery but it can also be caused by other surgeries, injuries, infections, burns and trauma. There is no cure for lymphedema, only management.
If lymph nodes have been removed there may not be any noticeable swelling because the system is currently able to handle the normal load but the potential for formation of lymphedema is there for life. Education is given to the client on prevention of lymphedema in such cases.
Combined Decongestive Therapy
Lymphedema can be successfully managed with CDT, Combined Decongestive Therapy. This includes skin care management, MLD (manual lymph drainage), compression and exercises. This requires special training on behalf of the therapist. Laura Dear, RMT successfully completed her CDT training through the Vodder Academy in 2021.
The initial visit and assessment is 75 minutes. It consists of review and elaboration of the health history, assessment of the affected structures, measurements of the limb if required, and education for the client on lymphedema and the reasons for why we do what we do. Then there is development and discussion of a treatment plan to which the client would need to consider and consent, as well as any indications for the need for compression in the form of bandaging or garments. In some cases there could be time for some treatment during that initial visit.
Manual Lymph Drainage
Manual lymph drainage, MLD, is hands on light, alternating, repetitive techniques that enhance lymph flow, fill lymph vessels and soften fibrosis. The length of the treatment depends on the individual pathology and is discussed in the treatment plan. Along with the management of lymphedema, lipedema and venous insufficiency, it is useful in reduction of swelling associated with pre and post surgery and joint replacements, burns and traumatic injuries, and it can help treat the symptoms of sinusitis and many other conditions.
MLD and CDT is also used in the assessment and management of lipedema and venous insufficiency.
Please call Laura at 902.892.7334 if you have questions or would like to book an assessment or appointment.
Compression garments
Fitting and ordering
The use of flat knit compression garments is essential in lymphedema management. Having the right garment and fit for your needs and lifestyle helps to support the veins and lymphatic vessels, helps to keep the limb from refilling and helps containment of the tissues. It also helps reduce fibrosis and maintain the gains achieved during Combined Decongestive Therapy.
Laura Dear is able to measure you and help decide which is the right garment and compression level for your needs. You do not need to be a client of Laura's to book a fitting and order compression garments. Simply hit the Book Now button and under services click "fitting" to schedule an appointment. There is no charge for fitting (unless you want the measurements to take elsewhere to order, then it is charged at the regular lymphedema therapy rate).
Laura fits and sells garments through Jobst, L&R Canada, and now Mediven. Custom or Made to Measure (MTM) are usually best but there are Off the Shelf options if your measurements fall within the parameters. Night garments are also MTM and OTS and can help stabilize or even reduce lymphedema combined with daytime garments. Pricing depends on brand and accessories but they are all close in price. We can not give a price over the phone, just a range, as they are all a little different and there are sometimes comfort zones that can be added which affect the price.
All custom flat knit garments are made in Germany and take 10 to 14 days to arrive once the order is placed. If it doesn't fit right, most companies have a 45 day window that we can do a remake at no extra charge. Outside of that window it is a new garment.
Garments need to be worn all day, even during exercise! Cleaned at night, some are hand wash and lay flat to dry and some can go in the washer and dryer. They do need to be replaced every six months, but nighttime garments last much longer, up to two years, because you are not walking around with them, just sleeping.
Please call Laura if you have any questions.