Inpatient Lymphedema Care at Siskin Hospital

Inpatient patient care.

INPATIENT CARE AT SISKIN HOSPITAL

The Lymph Notes team noticed an increase in the number of inquiries about inpatient treatment for lymphedema. One part of the problem is locating an appropriate facility, and another important issue is knowing whether the facility actually provides the specialized program to meet your lymphedema needs.

Our thanks to John Jordi of Siskin Hospital for Physical Rehabilitation ofChattanooga, TN for providing information about their program. 

WHO IS ELIBIBLE FOR ADMISSION AND HOW LONG DO THEY STAY?

Admission to this program is limited to adult stage III lymphedema patients and requires a written order from the patient’s physician. Usually these patients are experiencing an alarming degree of swelling in one, some, or all limbs, plus extreme weight gain. Often this condition has robbed these patients of their mobility so that they are unable to care for themselves. In addition, other serious medical conditions may be present.

Once admitted, most patients spend approximately 4 weeks receiving intensive services aimed at reducing swelling and restoring function.

WHO IS ON THE SISKIN TREATMENT TEAM?

At Siskin Hospital, treatment of inpatient lymphedema patients is provided by Certified lymphedema therapists (CLTs). This treatment is based on the components of Complete Decongestive Therapy (CDT) and includes the following components of care:

• Manual lymphatic drainage (MLD)
• Compression
• Exercises
• Skin care

In addition to these treatments, the interdisciplinary approach of the inpatient program offers the advantage of in-house consultations for:

• Clinical nutrition
• Pain management
• Physical and occupational therapy
• Psychology

As needed, treatment is provided by rehab physicians, wound care specialists, and case managers who work to evaluate and assist the patients with care management.

TREATMENT AND COMPONENTS OF CARE INCLUDE:

The goals of the program are specific to each patient. Most often these goals are aimed at restoring, enhancing, and supporting the patient's maximum level of independence.

• In addition to receiving Complete Decongestive Therapy (CDT), patients are trained in self-care to enable them to continue their progress when they return home. Patients are encouraged to have a family member or friend to accompany them during the treatment. This individual receives training as a caregiver in case the patient is unable to manage self-care.
• The most important component of the inpatient experience is Manual Lymphatic Drainage (MLD) treatments twice a day. The morning session is 2 hours and the afternoon session is 1 hour. The morning session includes MLD, bandaging and exercise, and the afternoon session includes MLD and bandaging.

WEEKLY GOALS

The following is a sample of what an inpatient may expect:

WEEK 1

• Family or friend trained in bandaging techniques (1-3 days)
• Upper body exercise program begins
• Walking program initiated
• Saturday and Sunday: You will be on your own for bandaging. Do your best, as it will make the difference between good results versus great results the next week.

WEEK 2

• Self MLD training
• Walking program extended
• Weight training initiated
• All week you will learn how to decrease and manage the swelling of your limbs. You will continue this regimen at least once daily on your own.

WEEK 3

• Skin care training
• Home Exercise Program initiated
• Stair training or other resistance exercises
• Aerobic exercise (time permitting)
• This week you will be preparing for home and your long-term management.

WEEK 4

• Final instruction in Self MLD
• Final preparation of Home Exercise Program
• Review of program
• Measuring for garments
• Setting of 1 year goals

IN CONCLUSION The ultimate goal is for the patient to continue self-care, or to work with a caregiver at home, so that the progress made as an inpatient can be maintained in their home setting.

Our thanks to John Jordi, BS, PTA, CLT-LANA, program coordinator for providing this information about the Siskin program.

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Category: Living well with Lymphedema