Janet Wolfson

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by Janet Wolfson, PT, CLWT, CWS, CLT-LANA

In March of 2017, regular readers of this blog may recall "Making a Daily Difference in Preventing Pressure Injuries." I imagined a wonderful facility where staff went about their duties with a corner of their brain always attentive to how patients' diagnoses, activities, and comorbidities could affect the tendency to develop a pressure injury (ulcer). Magically, the appropriate prevention occurred.

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Lymphedema patients doing yoga

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

For a long time, it was debated whether patients with lymphedema should partake in an exercise regimen. Today, fears of overloading the lymphatic system and of causing injuries have been resolved by research findings; however, there are precautions to take, and some types of exercise are more beneficial than others. When done correctly, these exercises can improve strength, quality of life, and ability to care for oneself and others, increase range of motion, decrease pain, and even reduce edema. Lymphedema-specific programs have been developed by wonderfully creative and knowledgeable people, too. As always, patients must consult with a health care provider before embarking on a new exercise regimen. If you are managing a patient who lacks strength or full range of motion, has difficulty in daily activities, or has problems walking, therapists can help develop a safe program and improve deficits to work up to a recreational exercise program.

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Lymphatic System

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

Manual lymphatic drainage (MLD) was developed by Emil and Estrid Vodder in the 1930s. They dedicated their lives to the study of lymphatic anatomy and physiology. Since then, others have modified the original techniques, including Foeldi, Leduc, Casley-Smith, and Bjork. They all involve manual contact with the client, deep diaphragmatic breathing, stimulation of the lymph nodes, and movement of fluid from proximal and then distal areas. The manual contacts are slow, gentle, and rhythmic. Practitioners are typically occupational or physical therapists, physical and occupational therapy assistants, nurses, massage therapists, and physicians. Many practitioners, after a required 135-hour training program, complete the Lymphedema Association of North America (LANA) certification exam.

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lymphedema management and prevention

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

With increased awareness of the impact of the lymphatic system on all other systems of the body, there are now multitudes of research studies on lymphedema and thus new approaches and treatments by the medical profession. These include medications, prevention, detection, surgery, and regeneration. Despite cursory education on the lymphatics in medical school, research in the United States and elsewhere has managed to progress treatment.

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lymphedema and the lymphatic system

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

If you had a chance to read last month's blog on the lymphedema and the lymphatic system, you're probably still amazed that such a wonderful system that provides immunity and handles fluid in our bodies exists in such secrecy. This blog discusses what can go wrong with the lymphatic system. Because this network has many parts throughout the body, with cells that generated and living in different areas, whose complexity needs consideration with other disease processes or surgery, and must be constructed in 9 months of gestation... A lot could go wrong!

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the lymphatic system

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

When I talk to my patients with lymphedema, I often need to tell them about their lymphatic system. Beyond knowing of lymph nodes or glands in their neck, most don't recall having heard anything about it. Surprisingly, today's medical students often have less than one hour on the lymphatic system education in medical school.

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compression therapy for lymphedema

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

The intersection of wounds and lymphedema has been on my mind this week as challenging patients and a new reduction garment cross my dual specialty life.

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patient interview questions

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

I was recently listening to one of my favorite news sources, NPR, enjoying an interview with James E. Ryan, the author of "Wait, What? - and Life's Other Essential Questions". The premise was that asking the right questions can lead to a happier and more successful life. A physician called in to relate that this was something he had been doing in his medical practice. I couldn't have agreed more – the questions I ask my patients (and then listening to their answers) can go a long way toward making an intervention in their health care more successful.

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delayed wound healing

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

Delayed wound healing: how did it start, what are we doing to prevent delay, and what could we be doing differently when delay is noted?

If you have worked in wound care a long time, there are those wounds we recall that were a real puzzle. Why wouldn't they heal when we were doing everything right? Sometimes it is as simple as finding out that the client has been sleeping in a recliner instead of a bed, in which case edema and sacral wounds will suffer. Or perhaps that the patient has resumed smoking now that their mobility allowed getting outdoors.

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Neck Surgery

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

Recovery and treatment of the head and neck cancer or head trauma patient goes beyond the surgery. Modifications in diet, adapted ADL, instruction in self-MLD, and taking precautions to heart are essential components of recovery. Some patients may need compression garments to deal with the lymphedema.

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