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MLD therapy provides relief for edemaMany specialties under the umbrella of modern medicine afford the provider the satisfaction of seeing their patient get well again. This is true in a very tangible way for the physical therapists at New Ulm Medical Center who practice a specialized kind of massage called Manual Lymphatic Drainage, or MLD. MLD is part of a larger treatment program called Comprehensive Decongestive Physiotherapy (CDP). This treatment is often recommended for patients diagnosed with a wide variety of edemas or swelling. The most commonly known edema, says Jennifer Fuentes, a Physical Therapist and Certified Lymphedema Therapist at New Ulm Medical Center, is lymphedema. A variety of things can cause lymphedema, but it is most often related to lymph node removal or damage in the course of treatment for cancer. “There are over 600 lymph nodes in the body,” Fuentes said. “The body is able to compensate to a certain degree when some of those are removed or damaged. But, there comes a time when it is just too much.” When there is damage to the lymphatic vessels or the lymph nodes, the lymphatic fluid that naturally occurs in the body builds up. This most often happens in a limb, but it can also occur in the abdomen or chest. With this fluid build-up, a patient can have swelling, decreased mobility, muscle weakness and skin problems. Lymphedema is a progressive condition, Fuentes explained. “Once you have it, it never completely goes away. But there are things we can do to manage it,” she said. Although Lymphedema is the most well-known kind of edema, Fuentes said, there are a many patients affected by a variety of other types of edema. Like patient Susan Peterson, who has an edema with an unknown cause. Peterson’s began to experience edema when her weight more than doubled in a four-month period about a year ago. She has never been able to find out what caused her problem. “With MLD therapy, I went from not being able to walk across the room to being able to go for three mile walks,” Peterson said. “My quality of life has improved a lot. Without the physical therapy, I don’t know what I would have done.” That’s when Comprehensive Decongestive Physiotherapy is usually recommended. MLD therapy is just one part of CDP, Fuentes explains, “you can’t just do one part of the therapy, they all have to be done together and it is a big commitment on the part of the patient.” MLD therapy has been performed in clinics in the United States for about 14 years, but has been practiced in Europe for over 100 years. It is a special type of whole-body massage which is extremely gentle and is aimed at stimulating the lymph nodes in other parts of the body so they can help the nodes in the affected area. “Patients are very surprised that it is such a light massage,” Fuentes said. “It’s because the lymphatic vessels are very close to the skin’s surface and you are stretching them to stimulate them to move fluid along. It is a very relaxing massage – patients usually love it.” The MLD massage is usually required on a progressively decreasing schedule, starting out with five days a week for four weeks. Then the patient will come in three days a week for four weeks, and then a few more visits before starting on some kind of an ongoing maintenance program. Compression bandaging is another important part of the CDP therapy, and is the component that may take the biggest commitment from the patient. The patient is required to bandage the affected area of the body in several layers and that is usually worn for 23 hours a day during the intensive phase of the treatment. Sometimes the patient is unable to do the bandaging themselves and may require help from a family member, who is also making a big commitment to the success of the therapy. “The compression bandaging is helping to push the fluid out so that it can be distributed throughout the system and eliminated,” Fuentes said. “It is a very important part of the therapy.” It helps not only decrease swelling, but to soften the skin which can often become hard, leathery and inflamed with the swelling. When Peterson started her therapy, it took three hours a day to apply the compression bandages. But, when the therapy is at an end, it will take only fifteen minutes to apply compression garments to maintain the results. “Part of the reason Susan has had such success is because she’s done what was asked of her. She followed the program,” Fuentes said. “It is a very big commitment.” Exercise and skin care are the two remaining components of the CDP program. There are very specific, gentle exercises that must be done with the compression bandages on that are designed to decrease the swelling. As far as skin care goes, there are also very specific recommendations in terms of oils and lotions that should or should not be used to help return the skin to normal. Patient Bernice Loe is another success story. She doesn’t recall exactly how long it’s been, but said she has had edema in her legs “a long, long time.” After dealing with itching and redness on her legs and not being able to walk very much, Loe is now enjoying more walks and almost no skin irritation. “I have had very good results. Just look at my skinny ankles,” Loe chuckled. “And it’s the middle of the day.” MLD therapy can also be used to treat a variety of diseases from people with chronic vein problems, as was the case with Loe, to swelling due to wounds, post traumatic swelling and facial edema. “I had one patient who had two sinus surgeries and was having intense pain and tingling in her face,” Fuentes said. “With MLD therapy, we were able to completely reverse it.” Fuentes also said with a smile that she has had patients who say, “I had no idea there was therapy for this, I was just told I was fat!” Fuentes came to New Ulm Medical Center in August of 2005 after working at a specialty clinic in Kansas City where they specialized in treating these types of diagnoses. “My supervisor at that clinic was an international expert in MLD and had written papers and textbooks and traveled extensively to lecture on the subject. I was very lucky to learn from her.” Three other staff members at New Ulm Medical Center have similar certification training in MLD: Tammy Henle and Shari Kotten, both registered physical therapists and Mary Bauer, a physical therapy assistant. |
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New Ulm Medical Center
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