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Skiff therapist offering treatment for chronic swelling


August 3, 2017

More than 200,000 people each year are diagnosed with lymphedema, a common, chronic and sometimes debilitating condition. Through a specially trained therapist at Skiff Medical Center, local individuals suffering with lymphedema now have easy access to help.

Lymphedema happens when excess fluid, known as lymph, gathers in body tissues – most typically the arms and/or legs – and causes swelling (edema). This condition is not one that can be cured, but can be managed in a way that assists people regain comfort and quality of life.

“The ‘gold standard’ of treatment is complete decongestive therapy, or CDT,” said Nikki Stines, a doctor of physical therapy and certified lymphedema therapist at Skiff. “It’s a multi-step process involving skin care, wrapping, massage, remedial exercises and ongoing management.”

Most cases of lymphedema are considered secondary; that is, they arise as a result of damage to the lymphatic system. In a healthy person, the lymphatic system is designed to carry protein-rich fluids to the lymph nodes, which filter out harmful substances before the fluid is eventually deposited into the bloodstream. When the vessels of the lymphatic system are damaged or blocked and cannot carry the lymph away from the tissues, localized swelling takes place.

“The majority of patients with lymphedema have developed it as a result of certain surgeries, or traumas, like a crush injury, or from cancer treatments,” Stines said. “For example, about 40 to 50 percent of breast cancer patients end up dealing with some degree of lymphedema.”

For patient Marci Patro, there isn’t certainty as to what caused her lymphedema, but she suspects it was triggered by hernia surgery.

“For several years, I had issues with swelling,” she said. “Especially in the summer, my feet and legs would just be huge. Conventional treatments like compression socks didn’t work. I would swell anyway, and I’d have to cut the socks to get them off.”

When Patro’s family practice physician, Dr. Zack Alexander, learned Skiff was offering the specialized treatment for lymphedema, he referred Patro for CDT.

“This is a service we didn’t previously have in our area,” Dr. Alexander said. “Lymphedema is more common than many realize. I probably have at least one patient each week dealing with the condition. Nikki is a great communicator with both patients and doctors, and she is dedicated to helping people feel better.”

Patro agreed, saying, “Seeing Nikki was wonderful. She is very bubbly and very compassionate. She spent a lot of time with me, going over my medical history and explaining what I could expect with treatment.”

Stines uses a light-pressure massage known as manual lymph drainage, followed by special wrapping, using specific materials and technique. “The combination of short-term wrapping and manual lymph drainage techniques have been shown to have the greatest reduction in swelling,” Stines said. “After patients wear the wraps for a short period of time to reduce the edema, they are then fit for a garment to wear once their swelling has plateaued.”

Patro said she saw great results from the wraps, which she would wear continuously. “It’s been wonderful. People have commented that, even with the wraps on, they can tell how much thinner my legs are. Now I’m able to be up and active. Before, my quality of life was horrible. All I could do was sit with my feet up. Otherwise, I swelled like a balloon. I would have to lie down or sit in my recliner. All I could do was veg out in front of the TV. It wasn’t a pretty sight.”

“People with untreated lymphedema can experience heaviness, achiness and discomfort,” Stines said. “They also deal with having compromised skin, because swollen tissues have a harder time healing. Part of treatment is educating patients on ways to protect the affected limb, including avoiding blood pressure cuffs and injections on that side, and preventing insect bites and sunburn.”

This preventive care has been shown to have significant benefits for patients, said Stines. “CDT has been found to reduce the risk and episodes of cellulitis, a common and potentially serious bacterial skin infection. As a result, it decreases the incidence of hospital stays for those with lymphedema and edema.”

Now that Patro’s condition is under control, she only needs an annual check-up with Stines. She said she is so grateful to have had access to this service. “I can’t say enough about Nikki. She and this program are so great.”

Stines, who has been at Skiff since 2015, received her doctor of physical therapy degree at Des Moines University, and pursued additional training to become certified in lymphedema treatment.

“Across the country there is a shortage of certified therapists,” she said. “There are a lot of patients who suffer with this and don’t have access to the care they need. There were no clinics or therapists in Newton offering it locally. Now that I have this training, patients throughout Jasper County have increased access for the care they need.”

Skiff Medical Center
204 N. 4th Ave E.
Newton, Iowa 50208
Phone: (641) 792-1273
Toll-free: (888) 792-1273

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Skiff Medical Center, a member of Mercy Health Network, is located in Newton, Iowa. We provide services to Jasper County residents in all major health areas, including general surgery, orthopedic surgery, radiology, obstetrics, emergency medicine, hospice, home care, laboratory, respiratory, audiology, physical therapy, occupational therapy and speech therapy. The Skiff Specialty Clinic hosts more than 20 physicians specializing in cardiology, dermatology, ENT, gastroenterology, nephrology, neurology, oncology, pulmonology and urology.
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