Addressing Challenges and Misconceptions About Lymphedema

The title of my presentation is “Hidden in Plain Sight” and it's understanding the edema–lymphedema continuum and how it impacts tissue healing.
 
My name is Dr. Heather Barnhart. I am a physical therapist, a PhD certified wound specialist, advanced wound care certified. I hold a LANA credential for certified lymphedema therapist as well as being dual certified in lymphedema and wound care.
 
Time. If there was one thing I had to think about as far as the challenge is the time. A lot of these patients are time intensive to treat them adequately with the skin and wound care needs, the manual lymphatic drainage, application of compression and of course the education that goes with that.
 
And I think it's really important that another challenge along with the time component is a lot of times we don't get enough authorization to really provide the services that they need. If we're given eight visits, a lot of these patients require many treatments over the period of several months.
 
And so at accessibility, especially from coverage through insurance companies, but also the time to be able to treat these patients adequately. It sometimes runs into issues with productivity and things, but these are time intensive patients.
 
So we really need to be in an environment that understands that to allow for adequate appropriate intervention for these patients.
 
I think it still gets missed. I think more awareness is happening about what lymphedema is and they're getting better about recognizing it, but we still don't do enough with respect to proper diagnosis and recognizing it in so many other conditions.
 
It's directly related to obesity. It's directly related to some of the fat disorders. It's the leading cause of secondary lymphedema in the United States is phlebolymphedema.
 
So lymphedema of venous etiology. So it's really recognizing it for what it is, but appreciating that lymphedema is actually on a continuum. So there's a lymphatic insufficiency component where you end up with chronic edema that could be due to an infection.
 
It could be due to surgery. It could be due to an ankle sprain. All the way to the other end of the spectrum, which is truly the disease of lymphedema where there's a true impairment. So I think it's really important people recognize it for what it is, know the signs and symptoms, and if they're not comfortable being able to refer within their network to get that person the right diagnosis so that can lead to the right interventions for their care.