CLT – treatment exam question with complete solutions

CLT – treatment exam question with complete solutions to adjust to hypersensitivity with light MLD and bandage techniques pain usually diminishes within few sessions - MLD: NOOOOO unless combined with lymphedema, then for analgesic effect with or without compression - Treat WHOLE BODY, unlike in LDA, include regional lymph nodes, lighter pressures in MLD and may need to use compression in initial tx or not, always with padding (anterior tibial area with non-dense materials (Komprex) - Custom made compression, pantyhose with higher compression - Short intensive phase for modest vol reduction o D/C bandaging, transition to garments only for LT (daytime only), bandages in PM o Self-bandaging is NOT productive o Edu on long-range expectations and supportive lifestyle - Caloric balance: anti-inflammatory, Atkins (high fat/protein), MINIMAL simple carbs, reduce dairy/gluten - meat/grains should be only a CONDIMENT - Exercise program to improve lymphatic pumping (aerobic/stg/conditioning/walking in compression garments,) - Weight loss PRN - In absence of LDA o Compression § Stg = 8-15 mmHg - 20-30 mmHg § High waist leggings with ankle length or open or closed toes per pt preference Protein-losing enteropathy - Answer-high-protein diet (MCT) inc Ca drug=Octreotide bowel disease (Milroy's disease) (combined insufficiency) - High-protein diet supplemented with MCT (medium chain triglycerides) - Protein/blood infusions (sometimes) - Octreotide drug Abn protein levels + generalized edema - Answer-prompt renal testing HNL - Answer-decongest trunk FIRST (sandwich technique) stationary circles OPEN CELL for HNL flattening pads ONLY compression at NIGHT (opp from UE/LE/truncal) - Compression: HIGH risk, must check for contraindications/risk for CVA/clot/hypoxia, but recommended immediately post-MLD with flattening pad under a wrap/garment (regardless of edema stage) o Foam padding: improves uniform pressure distribution to tissues § Held in place by short-stretch bandage or off-the-shelf compression garment o "Chip bags" / "Schneider packs": softening pads used prior to MLD when pitting edema is present, softens edematous tissue and inc skin pliability/responsiveness to tx (worn 30 mins prior to MLD AND during trunk decongestion portion) o 3-4 hours minimum wear time of compression immediately post-MLD, more if tolerable