Lymphedema Management Program at Valley

What does the Lymphedema Management Program offer? 

Certified lymphedema therapists utilize Complete Decongestive Therapy, the gold standard of lymphedema treatment, and it consists of four parts:

1. Compression: Short stretch bandages are used to reduce the volume of the affected area and are specially designed for the treatment of lymphedema. They should only be used by a trained lymphedema therapist or by patients/caregivers who have received training.

2. Manual lymphatic Drainage:  A massage technique designed to improve lymphatic flow. 

3. Exercises: Low intensity exercise prescription; VMC’s Lifestyle Medicine department offers several exercise programs to meet patient’s needs.

4. Patient Education
•    Skin Care: Essential due to the increased risk for infection
•    Diet: Strategies to maintain a healthy weight through a balanced diet. For further nutrition questions, patients can be referred to Valley Medical’s Nutrition Clinic in the Lifestyle Medicine department 

What are the options beyond conservative lymphedema treatment?

While Complete Decongestive Therapy remains the gold standard of conservative lymphedema treatment, there have been recent surgical advancements that are offered at the UW Medicine Lymphedema Center of Excellence, including debulking procedures, lymph node transfers and bypass surgeries. Their clinic has strict criteria for accepting consultation referrals, and the lymphedema therapists at Valley can make recommendations for appropriate surgical patient candidates. They can also provide conservative management before and after surgery to optimize outcomes.

When should a patient be referred for lymphedema management?

• The clinic treats all types of lymphedema, whether it is primary or secondary, caused by malignancy, surgery, radiation, other trauma, filariasis caused by infection by Wuchereria bancrofti, or due to chronic health conditions such as congestive heart failure, kidney disease, and venous insufficiency.
• Areas of treatment include upper extremity, lower extremity, head and neck, and genital lymphedema.
• Patients can be referred to the lymphedema program at any stage of lymphedema, though early detection and treatment optimizes patient outcomes.
• If the patient also has wounds, please refer to the Wound Clinic first, who will then coordinate with the lymphedema program as indicated.

What are the goals and outcomes of the lymphedema treatment provided in the program?

• Reduce swelling to a normal or near normal size using Complete Decongestive Therapy, including manual lymphatic drainage and compression bandaging.
• Maintain reduction with compression garments and lymphedema pumps as indicated.
• Optimize function through patient education regarding skin care and exercise as well as
• Provide patient with tools and strategies to manage their lymphedema independently.

Who are the providers?

Valley Medical Center has three nationally-certified lymphedema therapists trained to treat lymphatic disorders: 
Julie Fulton MPT, CLT-LANA – Outpatient Therapy Services Clinic
Shannon Smith, OTR/L, CHT, CLT-LANA – Outpatient Therapy Services Clinic
Janelle Trippany DPT, CLT-LANA, PRPC – Lifestyle Medicine Clinic

Where can patients access lymphedema services?

Lymphedema Services are located in Outpatient Therapy Services as well as in Lifestyle Medicine, both located on the Valley Medical Center Campus.

How can providers refer patients to the Lymphedema Management Program?

• External Providers: Fax order to Valley Medical Outpatient Therapy Services, Fax: 425-690-9650; Phone: 425-690-3650
• VMC Internal Providers: Epic REF131 – Lymphedema Referral (see order form screens below).