Deborah G. Kelly A Primer on Lymphedema

ISBN 13: 9780130224101

A Primer on Lymphedema

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9780130224101: A Primer on Lymphedema
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Kelly (physical therapy, U. of Kentucky) introduces the reader to the basic information for the clinical management of lymphedema (a chronic disorder characterized by an abnormal accumulation of lymph fluid in the tissues of an extremity or other body part) within the context of the U.S. health care industry. After discussing the basics of the lymph system and the etiology of the disorder, Kelly discusses intervention options. Finally professional issues such as reimbursement under managed care systems, establishing a practice in lymphedema management, and resources available to professionals are discussed. Annotation c. Book News, Inc., Portland, OR (booknews.com)

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From the Back Cover:

A must-have resource!
Enticing, readable, and visually informative, A Primer on Lymphedema is the first North American text on lymphedema. A comprehensive resource for both novice and experienced clinicians alike, its broad scope of coverage provides relevant information that encompasses all health care fields. Readers will not only develop in-depth knowledge of the essential roles of the lymphatic system and the management of the symptoms of the abnormal lymphatic system, but also sharpen clinical decision making skills. Detailed discussions provide ample preparation for effective in-service presentations, provider relations meetings, communications with referral sources, intervention plans, and clinical specialization. Additional features include:

  • An engaging, concise, and logical writing style with extensive illustrations.
  • Clinical implications and case studies throughout that provide real-life examples.
  • Case studies from clinics around the United States.
  • Provocative quotes from worldwide experts in the field.
  • Graphs and information boxes that highlight difficult concepts.
  • Extensive current reference lists at the end of each chapter.

Excerpt. Reprinted by permission. All rights reserved.:

In recent years, health professionals in North America have devoted increased attention to patients with lymphedema and the treatment options available to them. The condition itself is not new. The signs and symptoms have existed but have been largely ignored or ineffectively treated for decades. With the significant incidence of lymphedema in North America and around the world, there is a clamor from patients and health professionals for more information, improved education, and increased access to effective treatment methods. Successful treatment options from Europe and Australia have attracted considerable interest since no prior method has been satisfactory in managing the symptoms over time.

In part because of improvements in health care delivery, the number of patients seeking treatment for lymphedema is significant. Statistics convey a wide range on the rate of incidence. Some have speculated that lymphedema will become more prevalent over time. Reasons for the size of this patient population include:

  • Improved survivorship following cancer treatment has allowed patients to live long enough to develop the symptoms, which can appear many years after surgery or other cancer treatment.
  • Aggressive sampling and dissection of lymph nodes for various types of cancer treatment, although on the decline, has been the accepted norm for many years.
  • Debilitating effects of radiation therapy are reduced now with more specific treatments, but like other systems in the body, the long-term effects to the lymphatic system may continue to surface for another decade before they begin to decline.
  • Incidence of certain types of cancers, such as melanoma and prostate, and subsequent treatment is still rising.
  • Assertiveness and awareness of patients seeking care contributes to the number of people identified with lymphedema.
  • Slow but steady improvement among practitioners in the recognition and accurate diagnosis of lymphedema has increased the number of individuals recognized with the signs and symptoms.
  • Access to the Internet has raised consciousness about the signs and symptoms of lymphedema, leading to improved detection.

As this patient population looks to the medical community for a response, professionals are seeking the most current information and education to return this group back to functional and normal, or near normal, lives. Currently, referring practitioners do not designate what level of education a clinician must have before treating a patient with lymphedema. It can be assumed, therefore, that new graduates as well as experienced clinicians are faced with the challenge of how to treat the signs and symptoms of this diagnosis and when to refer on to a specially educated clinician. As cited throughout this text, individuals with lymphedema must have their symptoms managed appropriately from their onset to minimize the sequelae. Symptoms usually become more profound with time. While intervention at any time in the disease process can lead to improvements, the most significant and lasting gains are seen when appropriate intervention is initiated as soon as signs and symptoms appear.

This is an exciting time for people interested in lymphedema and management of the symptoms. There are articles, now numbering in the thousands, that contribute to the information explosion on the lymphatic system. Many issues are on the table for discussion among medical professionals: scientific merit of current treatments, efficacy of treatment, adherence behaviors, measures of quality of life, patient satisfaction, clinical outcomes, certification, scope of practice, payment, use of alternative medical therapies, use of alternative compression devices, the paradigm shift in historical treatments, and the use of dietary, pharmaceutical, and surgical intervention as adjunct therapy. Watch the literature closely over the next few years for information on these topics. There is still much to learn about these and other issues. Among the most promising projects are investigations that may lead to possible breakthroughs in the use of gene therapy to de-bulk tumors, and the use of techniques for autotransplant of lymphocytes into lymphedematous limbs to reduce the symptoms of lymphedema.

My primary goal in writing this text is to provide an enticing, readable, visually informative resource for health professionals and students in professional programs. This text is unique in that it will serve many needs for a variety of health professions. The text will facilitate clinical decision-making and will provide information for inservice presentations, provider relations meetings, communications with referral sources, intervention plans, and clinical specialization.

Special elements are included in the text to enhance the learning experience for practitioners and students alike: excellent anatomical illustrations, color photos of actual patients, case studies, graphs, educational handouts to be copied, current references, and quotes from leaders in the field. The value and the venue of this book is broad so that buyers may purchase it to expand their knowledge of the lymphatic system, but could also use it to improve their documentation skills, and increase their understanding of current issues such as reimbursement and the disablement model of patient/client management. I have written with the mind of an educator, the heart of a clinician, and the will of an activist. It is my hope that readers will aspire to at least one of these roles by the end of this text.

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