Lymphedema is a condition that can occur when lymphatic pathways are disrupted. This can happen during cancer treatment as a result of several things, including surgery, lymph node removal, radiation, infection or trauma. Disrupting lymphatic pathways causes abnormal, protein-rich fluid to build up in certain parts of the body, causing inflammation and scarring of the affected tissues. It is a chronic (long-term) condition, but it can be managed to prevent infection and restricted range of motion.
While most cancer centers have lymphedema therapists, fewer than a dozen specialists practice in Western New York. Roswell Park Comprehensive Cancer Center has three on staff in its Lymphedema Clinic. Located on the ground floor of the hospital, the Lymphedema Clinic features private treatment rooms and a full gym with total body exercise equipment.
Natalie Kaleta, PT, DPT, CLT, and Karli Maciejewski, MS, OTR/L, CLT, met when they began working in the Lymphedema Clinic at Roswell Park in the fall of 2018. They quickly learned they had plenty in common: Both had worked as traveling therapists in several states and decided to return to their Buffalo roots around the same time. Both attended the Norton School of Lymphatic Therapy to become certified as lymphedema therapists. Filling out the team is Kate Olejniczak, MS, OTR/L, CT, another Norton graduate, who works with them part-time as an occupational therapist.
In the clinic, the therapists use a research-based approach known as complete decongestive therapy to treat lymphedema. This approach, considered the gold standard for care, consists of manual lymph drainage, compression bandaging, exercise and meticulous skin care. The therapists have the most current training in providing care in inpatient and outpatient settings. As patients progress and transition to managing their lymphedema at home, they receive an established long-term program. The therapists fit patients with the appropriate compression garments, give them a home exercise program, and often a pneumatic compression pump. Each patient is scheduled for regular follow-up visits to ensure the effectiveness of their home programs.
The clinic’s patient-centered approach makes it possible for a therapist to spend at least an hour in a private session with each patient. “Taking a hands-on approach to lymphedema management and consistently updating the patients on their plan of care represents the gold standard of care,” Kaleta says.
“More frequent visits can help patients be more active, with less heaviness in their affected limbs, while also enjoying a better range of motion. They also are likely to see an improvement in any skin irregularities and fewer episodes of chronic swelling.”
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Area’s most comprehensive treatment program
“This is a very special feeling, to get to know patients so well and to work with them so closely,” Kaleta says.
Adds Maciejewski, “We have the ability to see patients up to five times a week if necessary, providing the most comprehensive treatment program in the area. There are fewer than a dozen certified lymphedema therapists in Buffalo and the surrounding suburbs, so we feel fortunate to have three therapists who work closely together, right here at Roswell Park.”
Lymphedema can lead to higher risks of infection and restrict freedom of movement. Because Roswell Park’s therapists see their patients on a regular basis, they can monitor every patient closely and be on alert for even small changes in swelling. This allows for early intervention and overall improved quality of life for patients.