On the first appointment a full medical history will be taken. The patient will be assessed and given advice regarding their condition. Before any treatment begins further tests may be required and written consent is obtained from either the GP or Consultant.
Treatment of Lymphoedema follows the principles of the 4 cornerstones:
Compression. Multi-layered Bandaging after each MLD treatment
Skin care. Ensuring that the skin is kept clean and moisturised daily thereby reducing the risk of infection.
Exercise. An exercise programme specific to each patients needs.
In conjunction to the recommended 4 cornerstones the following treatments are used to enhance further improvement and reduce the need to be seen so often:
Kinesio tape. A specific skin tape used to enhance lymph drainage
Deep Tissue Oscillation Therapy. This treatment generates oscillation of the fluid in the tissues, making it more viscous and easier to drain and is used in conjunction with MLD therapy.
Low Level Laser Therapy (LLLT) is used during the treatment to help reduce pain and swelling. Improve the appearance of scars and soften fibrosis.
During the intensive phase the patient will be treated using MLD, skin care, exercises and Multi Layered Lymphoedema Bandaging (MLLB), this combination of treatment is commonly known as Complete Decongestive Therapy (CDT). CDT is performed 3-5 times weekly for three to four weeks depending on the patients needs. During CDT phase the patients is treated Holistically where their emotional, psychological and physiological needs are addressed including pain management and education.
During the maintenance phase the lymphoedema is managed using CDT. The patient is seen weekly or monthly depending on their specific requirements. Maintenance is achieved by educating the patient to preform Self Lymph Drainage at home, skin care and exercise regime. The wearing of compression garments is vital in maintaining volume reduction and should be replaced regularly.
Compression during the Intensive phase and following each treatment thereafter is achieved using Multi Layered Lymphoedema Bandaging (MLLB). Following the intensive phase, the patient is fitted with compression garments. At the Bio-Health Centre we are trained to measure and fit custom-made garments from HC21, BSN Medical and Jobskin. Medi, Jobst and Actilymph ranges of ready to wear ‘off the shelf garments’ are also available. Patients can be measured and fitted with the custom made CircAid and Farrow Wrap compression systems.
Taking good care of the skin is important because it will reduce the risk of developing an infection, such as cellulitis. A daily routine in skin care is given to follow, where the skin is kept meticulously clean and checked for cuts or scratches or any signs of infection. At the Bio-Health Centre we advocate the use of organic Tea-Tree body lotion with a good quality Lavender added.
Remedial exercises are designed to strengthen the muscles that are involved in lymph drainage. Each patient will be given their own personalised exercise plan that will be tailored to their requirements and ability.