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Congratulations to Maddie Engelstad, MOTR/L, RiverView Health’s newest Certified Lymphedema Therapist (CLT). Engelstad provides lymphedema management through Home Care and Rehab Services.

Lymphedema is a non-curable, chronic condition in which excess fluid collects in tissues, causing swelling that can be severe and debilitating.

The lymphatic system is part of the immune system. It moves fluid through the body, picking up waste, bacteria, and viruses. Lymph nodes filter out the waste and flush it from the body. When something goes wrong, the fluid backs up in the tissue, and sometimes vessels are blocked. Lymphedema often causes swelling, restricted range of motion, and pain or discomfort.

More than 10 million Americans live with lymphedema or lymphatic disease. There are two types of lymphedema:

• Primary lymphedema is caused by a malformation of the lymphatic system and is most common in women. Primary lymphedema may present at birth or develop later in life, often during puberty or pregnancy. Primary lymphedema is most common in the legs.
• Secondary lymphedema results from damage to the lymphatic system. The most common cause is surgical procedures such as mastectomies and lumpectomies with radiation and/or removal of lymph nodes. However, secondary lymphedema may also develop due to traumatic injury, infection, or severe chronic venous insufficiency (vascular system overload).

Cancer treatment survivors, including those of melanoma, breast cancer, prostate, and ovarian cancer, are susceptible to developing lymphedema. The lymphatic system plays a role in AIDS, diabetes, heart disease, rheumatoid arthritis, lupus, and cancer metastasis. Physical trauma can also result in lymphedema and is a major cause of lymphatic disease among wounded veterans.

Engelstad is in good company as a CLT at RiverView. She joins fellow occupational therapist Michelle Moen and physical therapists Lori Hefta and Ashley Leines in certification.

RiverView’s CLTs offer Complete Decongestive Therapy (CDT), an intensive program that combines different treatment approaches, including

• Manual lymph drainage
• Compression and bandaging
• Skin care
• Exercise

Studies have demonstrated the effectiveness of CDT for improving lymphedema symptoms.

“Lymphedema management can improve pain, swelling, skin integrity, and range of motion,’’ Engelstad shared. “It can also improve overall circulation and decrease susceptibility to infection such as cellulitis.’’

Along with specialized massage techniques and compression garments/wraps, RiverView therapists may also use a machine similar to a blood pressure cuff to gently move fluid out of the affected area, making movement and everyday activities easier for the patient. Activities that get the heart pumping and make breathing harder can also bring down swelling.

“So often, I hear patients describing themselves as feeling ‘lighter’ or that their skin isn’t as ‘tight’ following treatment sessions,’’ she reported. “The main feedback I receive from patients is they are much more comfortable following lymphedema treatments.’’

Engelstad encourages anyone suffering from lymphedema to try CDT. “Every patient I have seen reports that one or more of the components of lymphedema management improves their symptoms. My goal is to find the combination of techniques to improve your pain and swelling and find a solution that works for you.’’

For more information on lymphedema services at RiverView, please call Rehab Services at 281.9463.