Empowerment
Navigating the Lymphoedema Therapy Maze
Finding the right therapist, or combination of therapists, is an individual thing and can be confusing. LASA has talked about this with many people living with lymphoedema over time and below are a few hints and tips we have gathered. What lymphoedema therapy is right for me? There are several methods of lymphoedema therapy including Vodder, Casley-Smith and Foldi, and what works for one person may not be right for another. It can take several tries with a few therapists before you find the combination of massage, laser and compression that works for you. Some people with lymphoedema see one therapist for all their therapy while others see several specialists. It is ok to try different therapists. Don't give up hope if the first one does not work for you. LASA Social Coffee Catch-Ups provide the perfect opportunity to chat with others who live with lymphoedema and share ideas with people who really understand. What to consider when choosing a therapistWhoever you see, whether it is a lymphoedema physiotherapist or lymphoedema massage therapist, they must be trained specifically in lymphoedema treatment. Some therapists provide 30 minute sessions while others provide 1 hour sessions. Some therapists will spend time teaching you skin care, exercise, diet and self management routines. Out of pocket costs will vary between clinics and therapists. Some therapists will accept the ‘Chronic Disease Management Plan’ and others may not so it is a good idea to ask and it’s ok to compare. It is important that garments are properly fitted and measured each time you receive them otherwise they may not be effective. It is recommended that garments be replaced every 6 months. Ensure you are comfortable enough to talk to your therapist about any concerns you may have with your treatment. Most people will find they get better outcomes when they have developed a good rapport with their chosen therapist, or team of therapists.
How can your therapist monitor your condition?
Therapists may use an L-Dex score to measure your progress. An L-Dex machine is designed to detect small lymphedema-related fluid changes in the limbs. Alternatively your therapist may measure the circumference of the limb or limbs which have or are at risk of swelling. Reduction or stabilisation of your score or measurement indicates improvement. Therapists will also look at you holistically considering other variables which may be impacting the swelling of your limb such as cuts, infection or medications that you may be taking. Your therapist should discuss and explain all of this with you and always advise your therapist of any changes you notice or anything you think may be important.
And how do you know if the therapy is working? The proof is in the pudding so to speak. In many cases, if you are adhering to the advice your therapist has given you, you could start seeing positive results after a few sessions. You may notice that your limb feels better or lighter or the skin texture or colour has improved. There may be less swelling with possible limb circumference reduction, reduced or no infections and improved skin integrity. If you are not finding improvement within a reasonable timeframe speak to your therapist about it as a different approach may be required. Your therapist may suggest other options or you may wish to consider another therapist who may use a different method. It is important to be patient, it can take a little time before you see improvement. Your first step is to discuss any concerns you may have with your therapist and if you still have concerns after that it is ok to seek a second opinion.
How Can I find a Lymphoedema Therapist in South Australia?
LASA gets this question all the time!
We have put together some information we hope will help you find a lymphoedema clinic near you.
Some key points to keep in mind
It is important that you find a qualified lymphoedema therapist for initial assessment, ongoing management and treatment of lymphoedema. Lymphoedema therapists may be Registered Nurses, Physiotherapists, Occupational Therapists, Remedial Massage Therapists or other health professionals who have completed a recognised training course in lymphoedema management. The Australasian Lymphology Association recommends only accredited Lymphoedema Therapists for an initial assessment and diagnosis and you can follow this link to find an ALA accredited therapist in your area. Out of pocket fees will vary between private clinics and therapists and private health insurance rebates may also vary depending on individual health funds and the type of lymphoedema therapist you are seeing. It is a good idea to check with your health insurer as well as the clinic or therapist to confirm any gap fees you will incur. It may take you a while to find the right lymphoedema therapist for you and it is ok to try a few. You may be eligible for the GP arranged ‘Chronic Disease Management Plan’ which provides some Medicare rebates so be sure to discuss this with your GP.
Public Lymphoedema Services in South Australia
SA Health lymphoedema services are expanding across SA. All require a GP referral and criteria must be met. Check our Resources page for more information.
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Empowering you through education and awareness
Lymphoedema and ExerciseExercise and Lymphoedema PDFInstructions for arm exercise PDFInstructions for leg exercise PDFExercises for leg lymphoedema - Link to YouTube Video
General InformationALA Position Statements - LinkCancer Council - Understanding Lymphoedema PDFBCNA Fact Sheet - Lymphoedema PDFBCNA Travel Tips PDF
BCNA Podcasts - Link
Links to our YouTube PresentationsLASA Lymphoedema 101Prof. Neil Piller Richard Roope Andrea Mangion-Australian Institute of Lymphoedema
LASA Webinars on YouTube
Cellulitis with Richard Roope, Sharon Tilley, Jan Douglass and Jennifer RitossaMeet the Researchers - Susan Witt and Prof. Piller The Important Role of Compression
You are not alone, people who live with lymphoedema share their storiesEmbracing your swollen legs - LinkElevating the voice of men with lymphoedema - Link
Looking for more detailed information?Breaking the Swollen Cycle PDFCellulitis and Lymphoedema: A Vicious Cycle - LinkMen and Lymphoedema - Link
