Waldo County General Hospital begins Lymphedema Treatment Program

Jan 12, 2013
Donna Hills, PT

With their new space, the physical therapy department at Waldo County General Hospital is beginning a Lymphedema Treatment Program. And that is making many people happy.

Ann Hooper, Imaging Department Manage, said she has been sending breast cancer patients with lymphedema to Brunswick for treatment. Recently, she had an 80-yr-old patient who couldn't travel that far, but whose arm was so swollen it was purple. "I'm delighted we're going to have treatment here," she said, adding "that will help a lot of people."

For Dianna Wing, who has lymphedema, being able to get treatments at Waldo County means she won't have to take a four-hour round trip in order to have a 15- to 30 minute appointment. "I am so excited they are going to do it," she said recently. "I'm really happy that I will get to stay in the community for treatment."

Lymphedema refers to swelling that usually occurs in a leg or arm. It is caused by a blockage in an individual's lymphatic system, which prevents a person's lymph fluid from draining well. The fluid builds up, causing swelling. Lymphedema is most commonly caused by the removal of or damage to a person's lymph nodes as a part of cancer treatment.

A small percentage of individuals are born with a rare, inherited condition, which causes problems with the development of the lymphatic system. The condition begins in infancy, but often doesn't show up for years.

Dianna was born with that condition, but it didn't show up until she was 13. It started in her left leg and later went into her right leg as well. "I haven't seen my left ankle since I was 13," said Dianna. Her parents took her to doctor after doctor to see what was wrong and time after time, she was told they didn't really know what was wrong and she would have to "learn to live with it."

That was difficult for a teenager and she was the subject of some teasing and ridicule. She rarely wears a dress because from the back, her leg goes straight up with no ankle present.

The condition is worse when the weather is hot and her skin would crack, which led to a cellulitis infection. She was given diuretics, which didn't help. Her leg would get painful because it was so heavy; it was hard to get her shoes on because her feet would swell. In the late '80s, she was sent to a lymphedema program in Bangor, and her leg was wrapped with an ace bandage for two weeks, but that didn't help either.

Then, a few years ago, her then-husband saw a show on television about lymphedema and said, "I think that's what you have." Dianna immediately made an appointment with her doctor, who sent her to a vascular doctor, who in turn sent her to the lymphedema treatment program at a Portland hospital.

For Dianna, it was almost a miracle, even though she was told that by going 30 years without treatment a lot of the damage had already been done. Still, she was thrilled to hear the experts say they could help her manage her condition, rather then "You just have to toughen up and live with it."

For the first two weeks, Dianna had to go to Portland every afternoon for treatment. At the end of each day, the therapists would wrap her leg and the next day, they would unwrap it and measure to see if the amount of fluid was being reduced.

After the two-week- stint, Dianna was given compressions stocking to wear during the day and compression garments to sleep in. During her last visit to Portland (she now goes every six months), she was excited when she was given smaller socks to wear. While Dianna is thrilled that she will be able to get her treatments close to home, she is even more excited that people may become aware of lymphedema and know what they have.

"It affects your daily life," said Dianna. "It's frustrating not to know what you have. I couldn't be happier that people will have a resource so they can get treatment early to minimize the affects and will learn how to manage it."

While Dianna was born with primary lymphedema, the more common type lymphedema is secondary lymphedema. It most often develops from cancer treatments, including when lymph nodes are removed during breast cancer surgery or from radiation therapy to a lymph node region. The swelling can occur within days, months or years after surgery.

The most common symptoms of lymphedema are swelling, a heavy sensation in the arms of legs, skin tightness, decreased flexibility in the hand, wrist or ankle, difficult fitting into clothing in a specific area, or a tight-fitting bracelet, watch or ring that wasn't tight before.

There is no cure of lymphedema. The treatment focuses on reducing the swelling and controlling the pain.

Donna Hills, a physical therapist at the hospital, will oversee the Lymphedema Treatment Program at Waldo County General Hospital. She recently complete training and became certified at the Norton School in Chicago.

She learned how to use a special light massage technique to manually encourage the flow of the lymph fluid out of the affected area by stretching the tissue, Similarly, she will teach patients light exercises that they can use to encourage the movement of the fluid. In other cases, she will wrap the affected limb, also to encourage the fluid to flow back out of the limb toward the trunk to the body to find an alternative route through the lymph vessels.

For new patients, she will work for five days in a row to drain the fluid and then bandage the area. After that, the patients will learn to do their own bandaging and to use a compression garment, which compresses the affected limb, again to reduce the swelling at first and later to prevent the limb from swelling in the future.

And as Dianna knows, it is good to catch the problem early.

Donna became interested in running the Lymphedema Treatment Program because of a young family member who two years ago had swelling in her leg, which turned out to be lymphedema. Fortunately, it was a fairly mild case and the family member is able to keep it under control through the use of compression garments and exercises.

Donna wants to be able to do the same for her patients.

If you have questions about lymphedema treatment or with to make an appointment, with a referral from you physician, please contact the Rehab, Services Dept. at WCGH at 338-9316.

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