Forms for your initial appointment
Please fill out and print the appropriate forms prior to your visit:
- New Patient Registration Form
- Consent to Bill Insurance / Privacy Form
- E-mail Consent Form
- Lymphedema questionnaire
- Patient Specific Functional Scale
Lymphedema Bandage Order Forms
MSU Rehabilitation Medicine offers a comprehensive Lymphedema program. The clinic is physician-driven and has been established to address the needs of individuals with a diagnosis or potential diagnosis of Lymphedema. We offer ongoing management of the patient from the initial diagnosis through treatment, and then regular follow-ups with our specialized team of healthcare professionals.
After the physical therapy assessment, patients will receive treatment 4 days a week for 2-4 weeks. You may require a clinic physician visit as well.
Treatments take place in a private room and may include:
- MANUAL LYMPH DRAINAGE (MLD)
- PROPER SKIN CARE
- DIET EDUCATION
- FITTING FOR COMPRESSION GARMENTS
- EDUCATION ON THE LYMPHATIC SYSTEM
- INSTRUCTIONS FOR HOME TREATMENT
- To provide individual education to patients and their families/caregivers about lymphedema.
- To provide outreach to the commlWlity to educate other healthcare professionals on the identification of Lymphedema and subsequent options for treatment.
- To ensure patients obtain the correct garments for the management of their Lymphedema.
- To promote prevention and continued care for lymphedema through the lifespan of the patient in order to prevent complications and possible hospitalizations.
- To provide specialty care by staff who are trained in Lymphedema.
Lymphedema is the accumulation of lymphatic fluid in the interstitial tissue which causes swelling, most often in the arms(s) and/or leg(s), and occasionally in other parts of the body. If left untreated this stagnant fluid not only causes tissue channels to increase in size, but also reduces oxygen availability in the transport system, interferes with wound healing, and provides a culture medium for bacteria which can result in infection. Lymphedema should not be confused with venous insufficiency edema. However, untreated venous insufficiency can progress into a combined disorder, which is treated in the some way as Lymphedema.