Issue link: https://www.massageandbodyworkdigital.com/i/1128556
Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 65 From the point of view of a hospice nurse or physician, providing manual lymph drainage is typically seen as an additional method to promote quality of life. diuretic therapy, decreased orthopnea (she was able to lie at 30 degrees without discomfort and was able to finally sleep in her bed), decreased dyspnea, improved ambulation, controlled fluid weight gain, and elimination of cellulitis infections. She also began attending social meal times. | Patient 3 A 97-year-old male lived in a skilled nursing facility. He presented with a terminal diagnosis of congestive heart failure. Secondary diagnoses included chronic renal failure, diabetes, early Alzheimer's disease, early Parkinson's disease, and severe kyphosis (excessive outward curve of the spine). Prior to his hospice admission, he had experienced recurrent cellulitis due to longstanding edema in his lower extremities. Both legs were hardened by a significant fibrosis rubra. Recommended by his physician, therapy for this condition included high doses of diuretics and ACE bandages, which were worn throughout the day. The patient spent most of his time in a wheelchair, as he was unable to lie in bed comfortably, sleeping upright in a recliner at night. The main concern was to address the lymphatic fistulas that repeatedly led to cellulitis and to provide the least restrictive intervention possible since the patient intensely disliked living with ACE bandages binding his legs. Observation prior to therapy revealed brutalized tissues damaged by constant ACE bandaging. This resulted in a tourniquet-like appearance with tissue creases caused by an improper pressure gradient. The goals were to mobilize lymphatic fluid in order to decrease interstitial fluid stasis, eliminate occurrences of cellulitis, promote well-being, restore normal tissue volume appearance as appropriate with disease progression, and increase functional mobility. With physician and hospice team approval, the following interventions were initiated: (1) The nursing staff were trained in short-stretch bandaging techniques, to be applied four days a week with a break of 2–3 hours each day; (2) restorative nursing was implemented, providing him with walking and range of motion; (3) the aides were encouraged to lotion massage the patient; (4) MLD was provided on a varying schedule, from twice a day, five days a week to three days a week, depending on his condition and need; and (5) Swedish massage and other modalities were provided as treatment for the kyphotic curve. Therapeutic effects were noticeable within two weeks. The relationship continued for five months. Thereafter, because of improvement, he was discharged from hospice. The benefits observed by staff, family, and patient were: (1) significant decrease in the occurrence of lymphatic fistulas/cysts; (2) resolution of cellulitis infections; (3) increased energy level; (4) increased immune function; (5) decreased postural deficit; and (6) increased mobility. His physicians noted increased health and appearance of his legs, less edematous volume, a heightened vibrancy in well-being, and improved functioning, stating "MLD is clearly beneficial."