Webinar by Nasreen Starner, OTR/L, CLT – March 11, 2023
Review by Sharon Shepard, patient and LLN board member;
and Shelley DiCecco, PT, PhD, CLT-LANA, CI-CS
Lymphedema patients have long hoped for a surgical or pharmaceutical “cure” for this life-long chronic and debilitating condition. The microsurgery field has developed several procedures that offer great promise, but may set up unrealistic expectations for patients. Pre- and post-operative sessions with certified lymphedema therapists are essential for most patients undergoing lymphatic surgery. Nasreen Starner, OTR/L, CLT, works with lymphatic surgeons at Cleveland Clinic in this cutting-edge field. For more information, see supermicrosurgery for the Treatment of Lymphedema.
Lymphatic surgery patients, surgeons and therapists need to be aware of some obstacles to successful healing after surgery. Patients may have weeks to months of recovery time and often not see full results until around three years after surgery. Compression and therapy for lymphedema, wounds, and returning to activities of daily living are required for external and internal wound healing and helping the body find its “new normal” after major changes created by some surgeries. Obstacles include the price of compression garments/supplies, extends to self-care training lymphedema in general, how to manage post-operative swelling and pain, possibilities of nerve damage. Adjusting to posture changes, and altered body mechanics, addressing wounds and tissue changes (like fibrotic and scar tissues), signs of and how to treat axillary web syndrome, and emotional responses to the new altered self. Recovery from lymphatic surgery can be psychologically overwhelming, even if ultimately positive, so many patients may benefit from counseling sessions.
An obstacle must be identified before it can be overcome. Nasreen illustrates these obstacles with patient stories and pictures. She also communicates with surgeons and other therapists to develop protocols within her medical system to improve patient outcomes. As the supermicrosurgeries for lymphedema continue to expand to other facilities, patients and therapists need to be ready for the pre-and post-operative care requirements for successful healing.
Nasreen Starner’s webinar was sponsored by JUZO and JOBST with informative videos included.