WHEN WAS THE LAST TIME YOU SAW YOUR LYMPHEDEMA THERAPIST?
I often get calls from customers who would like to reorder but are unsure of the product they should be getting this time. When I ask if they have seen their therapist lately, they often say no. They don’t think about returning once they are released from care unless they have a new problem. Lymphedema and Lipedema are both chronic conditions; although they can be managed, they cannot be cured. Therefore, it’s a good idea to go in at least once a year to get an assessment of your condition. During your appointment, it’s also a great time to bring in your compression garments so your therapist can evaluate them for wear and effectiveness. If it’s been a while since you’ve seen your therapist or need help finding therapists, here are some guidelines to help.
FINDING A LYMPHEDEMA THERAPIST
Sometimes it can be a real challenge to find a lymphedema therapist, and possibly even harder to find a 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 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 treating lymphedema. Since lack of training can seriously affect your treatment, a licensing organization called the Lymphology Association of North America (LANA) created standards and testing to certify minimum training, knowledge, and experience. The National Lymphedema Network (NLN) also endorses these standards. Currently, these standards are strictly voluntary. However, this is an excellent 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). Learning about the lymphatic system should take up about one-third of these studies. Two-thirds of the training will be in the lab with the 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 qualifications 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, look for a therapist authorized 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. This is because there are many different areas of practice: breast cancer-related lymphedema, cancer-related lower extremity lymphedema, genital lymphedema, head and neck lymphedema, phlebolymphedema, pediatric lymphedema, lipolymphedema, 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 a patient’s need,” said Karen Ashforth, an OT, MS, CLT-LANA at St. Joseph Hospital.
Beth Buldgren, an MPT, CLT-LANA from DuPage Medical, said 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 primary signifiers of a good lymphedema therapist.
BEYOND EDUCATION AND TRAINING
Beyond the therapist’s 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 vital 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 the patient’s goals,” 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 someone you feel comfortable with and communicate with. Lymphedema is a chronic disease, so you will 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, “In Germany, it is five days a week. 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 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 that lymphedema is not curable past a certain stage. However, the relationship built is the foundation of a long-term relationship for years. The patient and therapist must realize that,” said Maria Geriane, a PT, DPT-CLT.
It’s important to remember that therapists are people, too, and that lymphedema can be a challenging disease. As this process is ongoing, don’t expect them to simultaneously solve all your lymphedema problems. Your therapist can only do so much! You also have to do your part in self-care and maintenance. It’s a team effort.
Disclaimer – This blog is for general information purposes only. Furthermore, the information contained in this blog is not a substitute for medical advice – always consult a licensed healthcare professional for advice on your specific condition.