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Congratulations to Lori Hefta, physical therapist in RiverView Health’s Rehab Services, on her recent recertification as a Certified Lymphedema Therapist (CLT). Hefta isn’t new to the service, though, as she began studying to become certified in 1998 and was originally certified in 2002. She has 23 valuable years of experience in the field.

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. This is most common in women. Primary lymphedema may be present at birth or may 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. Surgical procedures such as mastectomies and lumpectomies with radiation and/or removal of lymph nodes are the most common cause. However, secondary lymphedema may also develop due to traumatic injury, infection or severe chronic venous insufficiency (vascular system overload).

All cancer treatment survivors, including those of melanoma, prostate and ovarian cancer, are susceptible to developing lymphedema. Breast cancer survivors can be at a high risk for developing lymphedema and 100% of those treated for neck and head cancer will develop the disease. The lymphatic system plays a role in AIDS, diabetes, heart disease, rheumatoid arthritis, lupus, and cancer metastasis. Physical trauma can also result in lymphedema, a major cause of lymphatic disease among wounded veterans.

Hefta is joined as a CLT at RiverView by Michelle Moen, occupational therapist. Hefta and Moen work with all aspects of Complete Decongestive Therapy (CDT), an intensive program that combines different treatment approaches, including bandaging, compression garments, manual lymphatic drainage, exercise, and self-care. Many studies have demonstrated the effectiveness of CDT for improving lymphedema symptoms such as swelling and pain.

According to Hefta, specialized massage techniques, exercise and compression garments/wraps can help patients suffering from lymphedema. Gentle movements that squeeze the muscles in the affected limb can help fluid drain and make it easier to do everyday things. Activities that get the heart pumping and make breathing a little harder can also bring down the swelling. A trained therapist can use a machine, similar to a blood pressure cuff, to help move lymph fluid out of the affected area.

Hefta’s advice to patients is to stay proactive in their treatment regimen. “It can take time with trial and error to find the best combination of treatment approaches that work for you. It is a very individualized treatment. Early detection and treatment are key.’’

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

Pictured above: Lori Hefta

Pictured at top right: Hefta wraps the hand of a patient with lymphedema to help ease symptoms.