A LYMPHEDEMA THERAPIST
Sometimes it can be a real challenge finding a lymphedema therapist, and possibly even harder to find a really good one. Fortunately, there are resources out there to help you in your pursuit to find a therapist. But, what qualifies a medical professional to treat lymphedema? When you do find a qualified professional to treat lymphedema, how do you know if you’ve found a good one? What should you be looking for?
TRAINING AND QUALIFICATIONS
There are no mandated training standards for lymphedema therapists in the United States. Therefore, any therapist can set up shop as a lymphedema therapist with little or no training in the treatment of lymphedema. Since lack of training can seriously affect your treatment, a licensing organization called Lymphology Association of North America (LANA) created standards and testing to certify a minimum level of training, knowledge and experience. The National Lymphedema Network (NLN) also endorses these standards. Currently these standards are strictly voluntary. However, this is a good place to start when looking for a qualified lymphedema therapist.
LANA and the NLN state the minimum requirements for a lymphedema therapist are at least 135 hours of qualified instructional course in Complete Decongestive Therapy (CDT). One-third of these hours should be spent in the classroom learning about the lymphatic system. Two-thirds of the training is spent in the lab with hands-on treatment of lymphedema patients. LANA also requires recertification every six years to qualify.
Again, LANA is a volunteer certification, but it gives you a place to start when looking for a lymphedema therapist. However, some of the best and most experienced therapists I work with are not LANA certified. Therefore do not let this be your only qualification, but a starting point.
HELP – I CAN’T FIND A LANA CERTIFIED THERAPIST!
So what do you do if there is no LANA certified therapist in your area? What do you look for in a therapist? What qualification and what kind of training should you look for when finding a lymphedema therapist? I asked some of the therapists I work with, whom I highly respect, what they think a patient should look for in a lymphedema therapist. Here’s what they said:
Finding a CLT (certified lymphedema therapist) was high on their list of what to look for in a therapist. If they are not LANA certified, then look for a therapist who is certified by a reputable lymphedema school. Klose Training and Lymphedema Certification and Norton School of Lymphatic Therapy for lymphedema came highly recommended, as well as the Academy of Lymphatic Studies (ACOLS) and Vodder Academy International.
Another aspect to consider is the type of lymphedema you have. “Lymphedema therapists may have varying levels of experience with different facets of lymphedema. There are so many different areas of practice: breast cancer -related lymphedema, cancer-related lower extremity lymphedema, genital lymphedema, head and neck lymphedema, phlebolymphedema, pediatric lymphedema, lipolymphedema, and post-lymphedema surgery, to name some areas. In other words, a therapist might be great at working with a specific population, but not have specific experience in the area of a patient’s need,” said Karen Ashforth, a OT, MS,CLT-LANA at St. Joseph Hospital.
Beth Buldgren, a MPT, CLT-LANA from DuPage Medical, said that having “the educational background to treat any condition, knowledge of garments and options for compression, and staying up to date on the most recent developments in lymphedema treatment” are main signifiers of a good lymphedema therapist.
BEYOND EDUCATION AND TRAINING
Beyond the therapist education and training, the therapists I spoke with also believed a lymphedema therapist should be compassionate, caring and committed. “The ability to treat a patient as a whole person and encourage them to get stronger and more mobile” are key characteristics in a therapist, stated Katherine Jao, a PT-CLT at St Joseph Hospital. “The therapist has to be resourceful for the patient … they are looking for direction,” said Linda Roherty, a PT, CLT-LANA. “Someone who goes above and beyond, that helps the patient from day one of treatment to understand what the patient’s goals are,” elaborated Carie Pace, a PT, CLT, at Dupage Medical.
“A good lymphedema therapist is someone who not only has a good repertoire in lymphedema treatment, but also has empathy, good listening skills, creativity and the flexibility to work outside the box to fill the individual patient’s needs,” stated Ashforth. Above all, the therapist should be a person you feel comfortable with and with whom you can communicate. Lymphedema is a chronic disease, so you will most likely be working with your therapist for a long time. Therefore, you will want to have a good working relationship with them.
QUESTIONS TO ASK WHEN FINDING A LYMPHEDEMA THERAPIST
Here are a few questions that would be beneficial to ask before you make your decision:
- Are you a CLT (certified lymphedema therapist)?
- Are you LANA certified?
- Do you specialize in lymphedema, and if so, what type of lymphedema do you specialize in?
- How long have you been in lymphedema practice?
- How long will each treatment last? (“A therapist cannot expect to do MLD and bandage in any less than 60 minutes,” said Roherty.)
- How many days a week will I be in treatment? (Roherty explained that, “In Germany it is five days a week. Yes, that model can be adopted in the USA. Four to five times a week for two to three weeks for an uncomplicated limb, then three times a week for two weeks.” Studies have shown that less than this prolongs the treatment.)
- Who supplies the products for treatments?
- Do you provide compression garments? If not, how do you handle fitting and purchasing of necessary compression garments?
- On completion of treatment, will I be provided with a self care plan including exercises for lymphedema?
WORKING WITH YOUR THERAPIST
The relationship you have with your lymphedema therapist will hopefully be a long and rewarding one. “A good CLT must build a relationship with their patients and acknowledge the fact that lymphedema is not curable past a certain stage. The relationship built is truly the foundation of a long-term relationship for years to come. Both the patient and therapist must realize that,” said Maria Geriane, a PT, DPT-CLT at Amita Mercy Medical Center.
It’s important to remember that therapists are people too, and that lymphedema can be a challenging disease to deal with. Don’t expect them to solve all your lymphedema problems at once, as this is an ongoing process. Your therapist can only do so much! You also have to do your part in self care and maintenance. It’s a team effort. Together we are stronger! Together we are empowered to live our best life.