How to Choose a Lymphedema Therapist Medical Advisory Committee (MAC) National Lymphedema Network As a service to both lymphedema patients and therapists, the NLN has traditionally provided a guide to treatment resources in the quarterly Newsletter. Although the NLN can neither endorse services nor provide accreditation for these services, substantial effort is directed toward verification of accurate, up-to-date information. If you peruse the Lymphedema Resource Guide, you will quickly be confronted with a bewildering array of terms, codes and abbreviations. To assist you in the all-too-important choice of a therapist for your condition, we provide the following background information: Lymphedema Therapists Training Programs Lymphedema therapists come to this field from a variety of backgrounds, including nursing, physical and occupational therapy, and massage therapy, among others. While the traditional training programs for these careers provide some background for treatment of lymphatic disorders, most therapists require supplemental training within programs devoted to the education of lymphedema therapists. These programs vary in the course content and the requisite hours of training. Since the care of lymphedema is quite complex, more training generally translates into better care. We feel that a minimum of 80 hours of instruction is desirable and that above 120 hours is ideal. Training programs are categorized in the resource guide to indicate the extent of training delivered to the trainees. In addition, we feel that a good training program should incorporate approximately 1/3 of the training in theoretical instruction, including anatomy and physiology of the lymphatic system, and that significant "hands-on" mentoring be provided to the trainees. We make every attempt to ascertain that these minimal requirements are met by the programs listed in this Resource Guide, however, currently no standards for treatment or training exist in the United States. Independent Therapist or Treatment Facility? The mainstay of lymphedema treatment is felt to be decongestive lymphatic therapy (CDT), which is comprised of several elements: 1) skin care 2) manual lymphatic massage 3) bandaging 4) exercises and 5) instruction in self-care. We feel that it is a minimal requirement that any treatment resource for lymphedema provide each element of this care to patients. In addition, we feel that additional attributes characterize a treatment resource as a lymphedema center (vs. an independent therapist): to receive this designation, we feel that the organization should provide continuity of care (you should always have the ability to communicate with your therapist[s] about the status of your lymphedema and the potential need for reassessment or a change in therapy) and at least two (2) of the following attributes: Direct onsite supervision/administration by an MD; Garment fitting services (certified fitter on staff or refer to qualified, certified outside source); -A support group; -Onsite podiatric services by a licensed DPM; -Physical and/or occupational therapy. Excellence of care is the goal for both treatment facilities and independent therapists
Bandaging is essential to treatment! Some information about different schools or courses teaching CDP/MLD: Foeldi School in Germany: Course length: 180 hours, 20 days. Accepted as students: MD, PT, MT Dr. Vodder School of North America: Course length: 160 hours, 20 days. Accepted as students: MD, RN, PT, OT, MT Dr. Bruno Chickly, Lymph Drainage Therapy, Upledger Institute Course length: 140 - 170 hours, 18 - 22 days. Accepted as students: MD, RN, PT, OT, MT, Physician Assistant, PTA Lerner Lymphedema Services Academy: Course length: 135 hours, 14 days. Accepted as students: MD, RN, PT, OT, MT Academy of Lymphatic Studies, Joachim E. Zuther Course length: 135 hours (+), 14 days. Accepted as students: MD, RN, PT, OT, MT Casley-Smith method, Lymphedema Therapy Center, Roswell, GA Course length: 135 hours, 14 days. Accepted as students: MD, RN, PT, OT, MT (Guenter) Klose Norton Training & Consulting Course length: 135 hours, 13 days. Accepted as students: MD, RN, PT, OT, MT Bergel Edema-Lymphedema Management, Compression Physical Therapy (CPT) Workshop: Course length: 100 hours, 10 days. Accepted as students: RPT, PTA, DC, OT, RN, LVN, ATC, LNP, possibly MT LeDuc Lymphedema Management Method: Course length: 48 hours, 6 days. Accepted as students: MD, PT, OT Linda Miller Breast Cancer Lymphedema Course: Course length: 32 hours, 4 days. Accepted as students: PT, OT Barbara Feltman Lymphedema Management of the Upper and Lower Extremities: Course length: 24 hours, 3 days. Accepted as students: PT, OT