What To Expect

The WakeMed Lymphedema program includes specialized treatment programs for persons with lymphedema or at risk for developing lymphedema.

What is Lymphedema?

Lymphedema is an abnormal buildup of fluid that causes swelling, most often in the arms or legs. The condition develops when lymph vessels or lymph nodes are missing, impaired, damaged or removed.

Who is at Risk? 

People who have had any of the following procedures may be at risk for developing lymphedema:

• Simple Mastectomy with or without axillary lymph node removal
• Lumpectomy with or without axillary lymph node removal
• Modified radical mastectomy
• Combined cancer surgery and radiation therapy to a lymph node region (such as neck, armpit, groin, pelvis or abdomen)
• Radiation therapy to a lymph node region
• Cardiac issues which cause prolonged swelling of the legs (such as congestive heart failure, atrial fibrillation)
• Chronic venous insufficiency
• Chronic kidney disease
• Orthopaedic injuries/surgeries with prolonged swelling present

What Should I Expect From Therapy?

1) Evaluation 

The therapist will begin treatment with an evaluation consisting of questions concerning past medical history, pain, lifestyle and what the patients goals are for therapy. The therapist will examine the patient's range of motion, measure girth of the involved body part, assess strength, skin integrity and possible other limiting factors affecting the patient.

2) Patient Education 

Patients are educated to the lymphatic system, the diagnosis of lymphedema, precautions and compression options.  Lymphedema varies from person to person. The therapist will design a treatment program based on the patient's condition, physical and emotional needs. There are different stages of lymphedema. Some patients may benefit from a Lymphedema education session only, to increase the patient's awareness of ways to prevent lymphedema.

3) Treatment 

Once a patient is evaluated, an individualized treatment plan is developed by the therapist and discussed with the patient. Treatment may consist of:

• Manual Lymph Drainage (MLD)- a light massage that re-routes lymph fluid around blocked or damaged areas
• Compression bandages and or compression devices- this may include special lymphedema bandages, the use of compression garments that are fit to the patient and/or night-time compression devices.
• Therapeutic Exercise-the patient is given special exercises to assist with the movement of lymph fluid.  Some patients may be referred to our aquatic therapy program to exercise in our therapy pool with physical and/or occupational therapists.
• Skin Care- the patient is educated in ways to reduce the risk of infection. The therapist uses lotions to keep the skin hydrated.
• Patient education.

The goal of therapy is for the patient to be independent with home management of lymphedema. By the end of therapy the patient should have the tools for successful self-management of lymphedema. As always, the therapists are available for consultation as needed.

All WakeMed Lymphedema therapists are licensed occupational and physical therapists and  Vodder techniques certified.

Additional Lymphedema Resources and Links

National Lymphedema Network: https://lymphnet.org/
Susan G. Komen Breast Cancer Foundation: www.Komen.org 
Academy of Lymphatic Studies: www.acols.com 
American Cancer Society: http://www.acols.com 
Circle of Hope Lymphedema Foundation: www.lymphedemacircleofhope.org 
Living Beyond Breast Cancer: www.lbbc.org 
Cornucopia House Cancer Support Center: www.cornucopiahouse.org 

Vendors 

Academy of Lymphatic Studies: www.acols.com 
Bandages Plus: www.bandagesplus.com 
Just Bandages: www.justbandages.com 
Bandage Supply: www.bandagesupply.com 
Compression Store: www.compressionstore.com 
Lymphedema Products: www.lymphedemaproducts.com 
Medical Stockings Online: www.medicalstockingsonline.com 
JoviPak: www.jovipak.com 
All Day Medical: www.alldaymedical.com 
Beacon Prosthetics and Orthotics: www.alldaymedical.com