Hi Steve,
Can you remove this email?
Thx, Lesli
AM Leigh Murray <lmurray@xxxxxxxxx> wrote:
Could you please remove my email from the listserve?Lesli R. Bell PT, DPT, CLT-LANA
*Leigh K Murray, PT, PhD*
Director/Professor, Physical Therapy Program
School of Behavioral and Health Sciences
2020 East Maple Street | North Canton, OH 44720
<https://www.google.com/maps/search/2020+East+Maple+Street+%7C+North+Canton,+OH+44720?entry=gmail&source=g>
(P) 330.490.7259* |* (E) *lmurray@xxxxxxxxx <lmurray@xxxxxxxxx>*
www.walsh.edu
[image: cid:image018.jpg@01D33B91.4B4BC570] <https://www.walsh.edu/>
[image: twitter-2016-email] <http://twitter.com/WalshUniversity> [image:
facebook_logo_2016-email] <https://www.facebook.com/walshu> [image:
Instagram-new-logo-email] <https://www.instagram.com/walshuniversity/> [image:
LinkedIn-logo-2016-email]
<https://www.linkedin.com/company/walsh-university> [image:
YouTube-social-square_red_24px]
<https://www.youtube.com/user/OhioWalshUniversity>
This message and any attachments are intended for the individual or entity
named above. If you are not the intended recipient, please do not forward,
copy, print, use or disclose this communication to others; also please
notify the sender by replying to this message, and then delete it from your
system.
Check us out on Facebook at
https://m.facebook.com/WalshUniversityDoctorateOfPhysicalTherapy
------------------------------
*From:* aptaoncology-bounce@xxxxxxxxxxxxx <
aptaoncology-bounce@xxxxxxxxxxxxx> on behalf of Lesli R. Bell <
lesli.bell@xxxxxxxxxxxxxxxx>
*Sent:* Thursday, July 1, 2021 1:34 PM
*To:* aptaoncology@xxxxxxxxxxxxx <aptaoncology@xxxxxxxxxxxxx>
*Subject:* [aptaoncology] Re: [EXT] Re: [External]Re: Lymphedema pump
question
CAUTION: This email originated from outside of the organization. Do not
click links or open attachments unless you recognize the sender and know
the content is safe.
Sent from my iPhone
On Jul 1, 2021, at 12:36 PM, Branas Andrea R <
dmarc-noreply-outsider@xxxxxxxxxxxxx> wrote:
There is not any evidence it’s better than proximal MLD and garments. But
for some people, the addition of a pump along with proximal MLD and
garments is better than not having it.
Many if the kids/adolescents/young adults we see at CHOP have primary
lymphedema. We are looking at t lifetime of self-MLD (or parent directed
MLD). If the family is compliant with garments and does MLD, a flexitouxh
may be a way to give the child independence. That child needs a long-term
system for managing their edem.
If a patient wants a pump instead of garments, I would not give jt.
Andrea
Get Outlook for iOS <https://aka.ms/o0ukef>
------------------------------
*From:* aptaoncology-bounce@xxxxxxxxxxxxx <
aptaoncology-bounce@xxxxxxxxxxxxx> on behalf of Cohn, Joy <
Joy.Cohn@xxxxxxxxxxxxxxxxxxxxxx>
*Sent:* Wednesday, June 30, 2021 10:01:47 PM
*To:* aptaoncology@xxxxxxxxxxxxx <aptaoncology@xxxxxxxxxxxxx>
*Subject:* [aptaoncology] Re: [EXT] Re: [External]Re: Lymphedema pump
question
Hi Andrea- the lack of really compelling evidence re; Flexitouch always
makes me hesitant to order one. Is it a helpful/not harmful adjunct to
regular self care ? (ie- consistent use of compression garments and
proximal MLD). I would say yes- a nice addition, but I have never seen
research evidence that it can take the place of the standard consistent
well fit compression garments and proximal MLD. I don’t think Flexitouch
is harmful to any patient, But I have seen far too many who don’t have good
control over their lymphedema when it is the only self care ‘tool’ they are
using….
Joy
Get Outlook for iOS
<https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Faka.ms%2Fo0ukef&data=04%7C01%7CBRANASA%40chop.edu%7C515d546f87804ad359a608d93c34328f%7Ca611241607b041a59bb1d146b575c975%7C1%7C0%7C637607018048844249%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=Cl5LWpa05Yk3cb6%2F9asSbik0WsB1w43ssIhOA%2BUa12E%3D&reserved=0>
------------------------------
*From:* aptaoncology-bounce@xxxxxxxxxxxxx <
aptaoncology-bounce@xxxxxxxxxxxxx> on behalf of Paddison,Nancy V <
nvpaddis@xxxxxxxxxxxxxx>
*Sent:* Wednesday, June 30, 2021 2:42:22 PM
*To:* 'aptaoncology@xxxxxxxxxxxxx' <aptaoncology@xxxxxxxxxxxxx>
*Subject:* [aptaoncology] Re: [EXT] Re: [External]Re: Lymphedema pump
question
I agree with the information from Andrea and Andrea thanks for the
additional reminder/review of the literature results.
We give appropriate patients a pump with the same criteria as mentioned.
Generally, this is for Stage 2 patients.
We also look at if the patient is compliant with skin care, exercise and
compression but cannot perform MLD or does not have a caregiver to do so.
If that is the case, we would recommend a pump, again on the lowest
settings. We exclusively recommend Flexitouch as it includes a trunk piece
component where others do not.
Nancy
Nancy V. Paddison, PTA, CLT-LANA, BA
Senior Physical Therapist Assistant
Rehabilitation Services
MD Anderson Cancer Center
713-792-3192
*From:* aptaoncology-bounce@xxxxxxxxxxxxx <
aptaoncology-bounce@xxxxxxxxxxxxx> *On Behalf Of *Branas Andrea R
*Sent:* Wednesday, June 30, 2021 12:37 PM
*To:* aptaoncology@xxxxxxxxxxxxx
*Subject:* [EXT] [aptaoncology] Re: [External]Re: Lymphedema pump question
*WARNING: *This email originated from outside of MD Anderson. Please
validate the sender's email address before clicking on links or attachments
as they may not be safe.
The information that has been passed to me (via lymph experts) was that
pumps cause long term damage to the lymphatic system. However, when reading
the literature, one thing that stands out is that the pump pressures and
times have decreased significantly over the past 20 years. And while none
of the literature says it, I would imagine that the decreased pressure on
the superficial lymphatic structures causes less (or no damage to the
system). That being said, we do need to be very thoughtful about who gets a
pump and why.
In the adult population (which likely carries over to teens/young adults),
there seems to be a net benefit to the use of pump when used in conjunction
with daily compression and some proximal manual lymphatic drainage. If our
patients are not willing to wear garments, they should not waste the time
and money to have a pump. There is no evidence that true lymphedema will be
reduced with the use of pump and no compression.
I work in pediatrics, and in this setting there is zero evidence that the
pump works. My guess is that it’s very difficult to study pumps in
pediatrics, partly because the pumps are not the right size for kids. My
experience in providing manual lymph drainage and bandaging in kids is that
the tissues are extremely pliable, and we are able to reduce most edema
quickly without the need for a pump. Offering a pump to a family prior to a
trial of PT makes them think that pumps are instead of CDT, not as an
augment to the treatments we already provide.
The 2 issues that I would worry about the most with use of the pump are
genital edema, and proximal volume overload (without the patient knowing
how/when to report/stop). If a patient is compliant with coming to PT for
education, manual lymph drainage and wearing garments, then a pump may be a
great way to give them long-term independence.
Bottom line is... if a patient is already compliant with wearing garments,
regular replacement of garments and finds that regular MLD is helpful...
then a pump on the lowest effective setting could give them long term
independence. If they are not wearing garments, then they should not have a
pump.
Andrea
Andrea Richtel Branas PT, DPT, MSE
Certified Lymphedema Therapist
Physical Therapist
Division of Rehabilitation
Children's Hospital of Philadelphia
branasa@xxxxxxxxxxxxxx
------------------------------
*From:* aptaoncology-bounce@xxxxxxxxxxxxx <
aptaoncology-bounce@xxxxxxxxxxxxx> on behalf of Louis-Ferdinand, Amelia <
alf@xxxxxxxxxxxxx>
*Sent:* Wednesday, June 30, 2021 11:52 AM
*To:* aptaoncology@xxxxxxxxxxxxx <aptaoncology@xxxxxxxxxxxxx>
*Subject:* [External][aptaoncology] Re: Lymphedema pump question
https://klosetraining.com/2013/11/22/to-pump-or-not-to-pump/
<https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.com%2Fv3%2F__https%3A%2Fnam10.safelinks.protection.outlook.com%2F%3Furl%3Dhttps*3A*2F*2Fklosetraining.com*2F2013*2F11*2F22*2Fto-pump-or-not-to-pump*2F%26data%3D04*7C01*7CBRANASA*40chop.edu*7C4346cef2c9f94265be1208d93bdf1f8f*7Ca611241607b041a59bb1d146b575c975*7C1*7C0*7C637606652355151095*7CUnknown*7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0*3D*7C2000%26sdata%3DtLqzjNbuIvo75A4IPS3uS9FS8oF071c5JLIgqetTlJ0*3D%26reserved%3D0__%3BJSUlJSUlJSUlJSUlJSUlJSUlJSUl!!PfbeBCCAmug!xS3UfVKIZ1sCxPGyWCzT5TJX8EBQnMzLW0Um9D02X1d_ib9s2DXwxwxmbGqJfyFhFA%24&data=04%7C01%7CBRANASA%40chop.edu%7C515d546f87804ad359a608d93c34328f%7Ca611241607b041a59bb1d146b575c975%7C1%7C0%7C637607018048844249%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=CAPdj5gxdgMbhO0T%2BIQiQSi6kbyaDHzheKatQWfs5yw%3D&reserved=0>
I don’t use pumps often so might not be the best in recommending specifics
but when I do or if I come across a patient who already has one and wants
feedback on settings I generally use this info. IF there is more updated
info would love feedback on that myself.
Best-Amelia
*Amelia Louis-Ferdinand PT, OCS, CLT-UE*
Clinical Specialist
<https://www.google.com/maps/search/325+E.+Eisenhower+Pkwy.,+SPC+5744++%7C++ANN+ARBOR,+MI++48108+%0D%0A+OFFICE:+734?entry=gmail&source=g>
Physical Therapy
Burlington Bldg Lower Level Suite 1
325 E. Eisenhower Pkwy., SPC 5744
<https://www.google.com/maps/search/325+E.+Eisenhower+Pkwy.,+SPC+5744++%7C++ANN+ARBOR,+MI++48108+%0D%0A+OFFICE:+734?entry=gmail&source=g>
|
<https://www.google.com/maps/search/325+E.+Eisenhower+Pkwy.,+SPC+5744++%7C++ANN+ARBOR,+MI++48108+%0D%0A+OFFICE:+734?entry=gmail&source=g>
ANN ARBOR, MI
<https://www.google.com/maps/search/325+E.+Eisenhower+Pkwy.,+SPC+5744++%7C++ANN+ARBOR,+MI++48108+%0D%0A+OFFICE:+734?entry=gmail&source=g>
48108
<https://www.google.com/maps/search/325+E.+Eisenhower+Pkwy.,+SPC+5744++%7C++ANN+ARBOR,+MI++48108+%0D%0A+OFFICE:+734?entry=gmail&source=g>
OFFICE: 734
<https://www.google.com/maps/search/325+E.+Eisenhower+Pkwy.,+SPC+5744++%7C++ANN+ARBOR,+MI++48108+%0D%0A+OFFICE:+734?entry=gmail&source=g>
-763-6464
<image001.png>
*From:* aptaoncology-bounce@xxxxxxxxxxxxx <
aptaoncology-bounce@xxxxxxxxxxxxx> *On Behalf Of *Mary Fisher
*Sent:* Wednesday, June 30, 2021 9:35 AM
*To:* aptaoncology@xxxxxxxxxxxxx
*Subject:* [aptaoncology] Lymphedema pump question
*External Email - Use Caution *
Hi all,
Just looking for what criteria you use to determine if someone would
benefit from a lymphedema pump. If so, what are the brands recommended?
What parameters?
*Mary I. Fisher, PT, PhD | Chair and Associate Professor*
*Board-Certified Clinical Specialist in Orthopedic Physical Therapy*
*Cer**tified Lymphedema Therapist*
300 College Park |
<https://www.google.com/maps/search/300+College+Park+%7C+Dayton,+OH+45469-2925?entry=gmail&source=g>
Dayton, OH 45469-2925
<https://www.google.com/maps/search/300+College+Park+%7C+Dayton,+OH+45469-2925?entry=gmail&source=g>
mary.fisher@xxxxxxxxxxx | Telephone: 937.229.5617 | Facsimile:
937.229.5601
she/her/hers
**********************************************************
Electronic Mail is not secure, may not be read every day, and should not
be used for urgent or sensitive issues
** This email originated from an EXTERNAL sender to CHOP. Proceed with
caution when replying, opening attachments, or clicking links. Do not
disclose your CHOP credentials, employee information, or protected health
information to a potential hacker**.
The information contained in this e-mail message may be privileged,
confidential, and/or protected from disclosure. This e-mail message may
contain protected health information (PHI); dissemination of PHI should
comply with applicable federal and state laws. If you are not the intended
recipient, or an authorized representative of the intended recipient, any
further review, disclosure, use, dissemination, distribution, or copying of
this message or any attachment (or the information contained therein) is
strictly prohibited. If you think that you have received this e-mail
message in error, please notify the sender by return e-mail and delete all
references to it and its contents from your systems.
** This email originated from an EXTERNAL sender to CHOP. Proceed with
caution when replying, opening attachments, or clicking links. Do not
disclose your CHOP credentials, employee information, or protected health
information to a potential hacker**.
--
