The Principles of Multidisciplinary Care include:
A team approach, involving core disciplines integral to the provision of good care, with input from other specialties as required
Communication among team members regarding treatment planning
Access to the full therapeutic range for all patients, regardless of geographical remoteness or size of institution
Provision of care in accord with nationally agreed standards
Involvement of patients in decisions about their care.
This integrated care can produce the best outcome for each patient. For more information about multi-disciplinary care follow http://canceraustralia.gov.au/clinical-best-practice/multidisciplinary-care.
The best clinical evidence is based on a review of all relevant randomised trials. However, this gold standard is often not available in lymphoedema research. Reliable evidence can be based on other studies and on the opinions of respected authorities based on clinical experience or the reports of expert committees.
The ALA endorses the International Lymphoedema Framework “Best practice in the Management of Lymphoedema”
It is important that you feel comfortable and empowered by the practitioner you see. Individual practitioners from various disciplines, training and experience levels will provide varying opportunities for you to achieve your own personal goals. You should always seek a second opinion if you do not feel totally comfortable with the treatment offered.
Lymphoedema treatment will incur various costs depending on where the treatment is carried out (public or private) and by the qualifications and training of the individual practitioner (category 1 or category 2 practitioner). There are various options for obtaining either Medicare or Private health fund rebates for lymphoedema services offered privately.
If you are treated by a Category 1 therapist you may be eligible for rebates under the Enhanced Primary Care Scheme. You will need to check with your practitioner that they are eligible for rebates under this scheme and arrange a referral from your GP.
It is encouraged that you contact your own health fund to discuss the level of cover you are entitled to in relation to your policy. Some states have compression garment funds. Ask your practitioner what is available.
See Compression Garments Schemes
The public hospital in your area may or may not provide outpatients services for lymphoedema management. You may find therapists working in public facilities listed on this register, however not all public hospitals offer lymphoedema management and the services offered may vary from hospital to hospital. Contact any hospital in your region to enquire if they provide public outpatient services for lymphoedema.
Compression garments are used to maintain reduction achieved in an intensive treatment, prevent progression of the lymphoedema or may be prescribed to reduce the risk of the onset of lymphoedema during air travel or other activities which may exacerbate existing lymphoedema. Your lymphoedema practitioner will be able to advise whether you need a garment and how to use it. Some practitioners may supply garments whilst others will refer you to an appropriate fitter.
It is preferable to use the unaffected limb for blood pressure recording, venepuncture, injections and IVI drips if possible. However the recommendations to protect the lymphoedema and lymphoedema-vulnerable arm from all these procedures are based on experience or anecdote in the absence of research.
Limited research has been undertaken following patients with arm lymphoedema who had venepunctures or injections performed in the affected limb. This research was performed by experienced nurses using correct infection control techniques. This research showed no worsening of the lymphoedema. There is currently no robust research evidence that blood pressure monitoring worsens or triggers lymphoedema.
Recent research has shown that the normal use and the exercise of the limb vulnerable to, or with lymphoedema has a positive effect and is important to good lymphoedema management.
It is important to prevent skin infection and cellulitis by careful skin care and cleanliness.
Infection may begin with a hot, red patch, pain or flu like symptoms. There does not need to be an injury or entry site for infection to occur. If you think you may have an infection related to your lymphoedema seek medical help immediately.
Download Management of Cellulitis in Lymphoedema
If lymphoedema remains untreated it may progress, however with treatment by a lymphoedema practitioner, careful monitoring and good self management this usually doesn’t occur.
How often will I need to see my lymphoedema practitioner?
What treatment do you recommend for my lymphoedema?
What is the evidence that the treatment you are recommending will work?
How much will my treatment cost?
Can I bring my partner with me to treatment?
Where can I get a compression garment fitted?
When should I wear my compression garment?
How much will my compression garment cost?
What type of moisturiser should I use?
What types of exercises can I do?
Is there anything I need to be careful of during my treatment?
Is there anything I can do to help during my treatments?
Are there any techniques I can use at home to help my lymphoedema?
Who should I contact if I have concerns about my lymphoedema?
Who should I contact if I notice signs of an infection?
How might my work be affected?
How might my lifestyle be affected?
Can I talk to someone about how I am feeling?
How do other people react to a diagnosis of lymphoedema?
Can lymphoedema be cured?