L S C
Lymphoedema Support Clinic
Donna Bastin
MONITORING PROGRAMME
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Initial Consultation - 30 minutes
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Review - 15 minutes
A full clinical history is taken at this appointment along with baseline measurements using the SOZO® device with L-Dex®. If you are coming to see me post-surgery or post-radiotherapy, treated areas will also be assessed for signs of surgical or radiation fibrosis and cording.
Advice will also be given on what precautions to take and the signs and symptoms of lymphoedema to be aware of.
At your review appointment, your L-Dex measurements are retaken and compared against your baseline measurements.
*REVIEW PROTOCOL
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Years 1 to 3 - every 3 months.
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Years 4 to 5 - every 6 months.
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Years 6+ - annually.
*It is important to contact me at anytime within these timeframes for
re-measuring should you be concerned that there has been an increase in the size of your limb or a change in sensation.
TREATMENT
Decongestive phase (1)
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Initial Consultation - 30 minutes
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Treatment - 30 to 60 minutes
If you have just developed lymphoedema or have existing lymphoedema that requires attention, then your treatment may start with the decongestive phase. This intensive phase will last for 2 to 4 weeks depending on the extent of lymphoedema and how well it responds to treatment.
Following your initial consultation, you will be required to attend clinic for review and treatment *twice weekly. These appointments will include manual lymphatic drainage and compression bandaging to reduce the lymphoedema as much as possible prior to measuring for a compression garment.
TREATMENT
Maintenance phase (2)
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Initial Consultation - 30 minutes
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Review - 30 to 60 minutes
The maintenance phase immediately follows the decongestive phase in order to gain maximum benefit from phase (1) and maintain control of the lymphoedema.
You will be measured for a compression garment at this appointment. The garment can be either off the shelf or made to measure and we can discuss your preferences and the best option for you during this appointment.
At your next review, your compression garments will be fitted and advice will be given on the easiest method of donning or doffing your garment. We will also discuss exercise, skincare and self-massage techniques that you can do at home.
An ongoing treatment plan is discussed and may require monthly or 6 monthly appointments to ensure the compression garments remain effective. Appointments may also include MLD to ensure additional fluid control.
TREATMENT for Post-SURGICAL SCARS, Post-RADIATION
or LYMPHOSTATIC FIBROSIS - Registered member of ScarWork UK
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Initial Consultation & treatment - 30 minutes
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Treatment - up to 30 minutes
Patients who experience pain or feel hardened areas around the scar, shoulder movement restriction, tightness when taking a breath or a sense of pulling, will benefit from a course of treatments to the scar, any fibrosed tissue and localised areas. Post-surgical scars can be treated 6 weeks following surgery and assessment. ScarWork treatment techniques are used to soften the appearance and colour of the scar, reduce any associated pain, soften the tissues and reduce any adhesions that may form whilst the tissues are healing post-surgery. Treatment with soft-tissue mobilisation using massage techniques will follow the initial clinical assessment. A plan for ongoing treatment will be discussed which may entail a number of visits to mobilise the fibrosed tissue and improve a number of post-treatment symptoms you may be experiencing. Guidance will be given on self-massage techniques.
TREATMENT with Manual Lymphatic Drainage (MLD)
pre/post-surgical procedures - Registered member of MLD UK
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Initial Consultation & treatment - 30 minutes
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Treatment - up to 30 minutes
Manual lymphatic drainage (MLD) is an extremely gentle form of massage movements and is often recommended by surgeons following surgery. MLD will help to reduce post-operative swelling, reduce the risk of infection, speed recovery and improve results. Treatment with manual lymphatic drainage techniques will follow the initial clinical assessment. A number of visits will be necessary to re-direct post-surgical oedema and improve a number of post-treatment symptoms you may be experiencing such as bruising, swelling and discomfort.
SOME REASSURANCE
A diagnosis of lymphoedema is daunting and some may find the prospect of treatment overwhelming. I can only reassure you that I will work together with you over time to make sure that the lymphoedema remains under control, adjusting your plan up or down as needed.
There may be times that you need to wear a compression garment around the clock, and other times when you only need to wear it for a few hours a day, or perhaps even miss a day or two. You may find that lymphoedema never becomes a major problem for you again, or that it is only a problem in certain situations, such as hot weather or activities involving heavy use of the arm. On the other hand, you may experience periods of worsening lymphoedema that require you to go through the decongestive phase (1) again at some point.
Every person is a little bit different and over time you will get to know how your body responds in certain situations and be able to take action accordingly.