In this course, Steve Norton expands on the fundamentals of lymphedema to address proper therapy standards, precautions and applications of complete decongestive therapy (CDT). He further addresses serious concerns to patients and practitioners including the risk factors for lymphedema and risk reduction, as well as the benefits to early intervention. In this course, the instructor will meet with Vera, a long-term lymphedema patient, to learn about her treatment, what made it successful, and what red flags were identified early on in the process. Upon completion of this course, the participant will understand how to successfully and knowledgeably manage care of the lymphedema patient.
Steve was certified in 1993 in Manual Lymph Drainage and Complete Decongestive Therapy through Lerner Lymphedema Services, PC the first fully specialized lymphedema treatment facility in the United States. He became the Chief Therapist of the Lerner Lymphedema Services, P.C. clinics located in Princeton, NJ, Manhattan, NYC and New Brunswick, NJ from 1994-1999. Over this period of time, Steve participated in the successful treatment of several thousand lymphedema patients. In 1995 and 1999 Steve completed further educational programs in lymphedema management at the Foeldi College, Hinterzarten, Germany and the European Congress of Lymphology. In addition to his clinical duties, he was chosen to provide instruct CDT courses at the Lerner Academy of Lymphatic Studies via hospitals, universities and clinics nationwide. In 1998 Steve co-founded an independent training and consulting company (Klose Norton Training & Consulting) offering CDT certification courses for medical professionals in various hospitals and clinical settings across the United States. Steve was among the first therapists in the United States to become Nationally Certified in Lymphedema Therapy by the Lymphology Association of North America (LANA) and in 2002 and 2003, was the first and only American lymphedema therapist to instruct an international group of clinicians at the world renowned Foeldi Clinic, Special Clinic for Lymphology, in Hinterzarten, Germany. Since 1995 Steve has been the host/presenter/producer of internationally distributed educational treatment videos and in 2005 Steve was filmed and interviewed by the Discovery Health Channel for its program “Medical Incredible”, demonstrating and discussing lymphedema therapy. This program aired in 130 countries and was viewed by 300 million people worldwide. Currently, as a consultant and CDT Clinical Instructor, he continues to provide services for private clinics, hospitals, independent physician's offices and firms within the lymphedema and related compression therapy industries. He regularly reviews lymphedema related manuscripts, and contributes to other clinical publications. Steve has authored articles on lymphedema management in professional publications and contributed to chapters and editorial revisions of the internationally renowned "Textbook of Lymphology" authored by, Prof. M. Foeldi & S. Kubik. Recently Steve authored a chapter on lymphedema in the medical textbook “Kuerer’s Breast Surgical Oncology” by Henry Kuerer, MD McGraw Hill 2009 and contributed a paper on Palliative Care and Complete Decongestive Therapy for the “Best Practices Document” of the International Lymphedema Framework Project. In 2013 Steve co-authored the internationally distributed textbook “Lymphedema Management; The comprehensive Guide for Practicing Therapists” with Joachim Zuther, published by Thieme, Stuttgart, Germany. Steve is a regular contributing presenter and organizer of various lymphedema related conferences such as the National Lymphedema Network Conferences (1994-2010), International Society of Lymphology Conferences (ISL) 1997-2007, Guthrie/ Klose Norton Lymphedema Conference (Denver 1999, Toronto, Ontario Canada 2002), University of Pennsylvania, Abramson Cancer Center/ Klose Norton Lymphedema Conference (Philadelphia 2003), International Union of Phlebologists (San Diego, Ca 2003) and various WOCN Conferences as well as the International Lymphedema Framework Project Conference in Brighton, England 2010. In 2003, Steve was appointed to the National Lymphedema Network (NLN) Medical Advisory Committee (MAC) serving until 2009 and is currently a member of the International Advisory Board for the American Lymphedema Framework Project (ALFP) and the Educational Committee for the International Lymphedema Framework (ILF). In 2009 Steve was appointed as Adjunct Courtesy faculty at the University of Missouri, Columbia School of Nursing. In 2007 Steve and the Norton School of Lymphatic Therapy were invited to instruct a group of physicians and nurses in Vellore India as the first formally organized course by a leading lymphedema education school. Starting in 2007 the Norton School presented the first organized CDT Certification in South Africa at the University of Western Cape then in Pretoria at Tshwane University of Technology and maintains this annual venue. In October 2007, Steve conducted a unique and extensive workshop at the 9th People’s Hospital, Shanghai, China demonstrating for the first time Complete Decongestive Therapy to Chinese medical professionals. Recently, Steve was invited to conduct a Staff Briefing to Congress in Washington, DC related to an initiative to establish new laws geared towards improving reimbursement for lymphedema.
This chapter emphasizes the therapeutic approaches that are utilized to reduce lymphedema. Participants will learn to appreciate the rationale for Complete Decongestive Therapy as opposed to singular approaches such as; pneumatic compression pumps, medications, elevation, compression garments or surgery. In addition, the benefits of Manual Lymph Drainage on an impaired lymphatic system and swollen body area will be discussed. Upon completion, participants will be able to gauge the contraindications to compression and Manual Lymph Drainage for persons seeking therapy.
Many red flags are associated with CDT as an intervention. This chapter will discuss the clinical reasoning of these red flags as well as the importance of a referral to a lymphedema specialist. The participant will also learn the limitations of an untrained therapist and the risks of using common modalities with a lymphedema patient. Other critical interventions for lymphedema will also be covered.
The gold standard therapy includes early identification and intervention. In this chapter, the participant will learn how to promote early interventions as well as the many ways an at-risk patient can reduce their chances of developing lymphedema.