Compression stockings·Lymph and lipedema

“The establishment of a place like this is long overdue“

“Het Lymfehuis” in Antwerp/Belgium

From Bauerfeind Life Magazin on 06.07.2016

It is the very first center of its kind in Belgium: a place where lymphedema patients, physicians and therapists come together outside of a hospital environment. The “Lymfehuis” in Antwerp is much more than just a treatment center – it’s also an essential meeting point.

he narrow town house looks like any other on this long arterial road in Antwerp: a two-story building with a clinker brick facade and a glass front facing the street. There’s nothing to suggest that it’s anything special , but a sign hung in the window, bearing the words “Het Lymfehuis” in small type, confirms that we’re at the right address. The sparsely furnished lobby indicates that the move into the building was recent – and involved only a bare minimum of equipment. “Everything is brand new right now,” confirms Tim Decock, a physiotherapist specializing in manual lymphatic drainage using the Vodder (MLDV) method, who is waiting by an open glass door on the top level. A therapy table is visible in the background; one patient is leaving the room, while three more are waiting, seated on white armchairs next to the reception desk. It is seven in the evening, and a sporty-looking woman is dashing up the final flight of stairs to the top level. Dr. Lore Fias, vascular surgeon and phlebotomist , has just come from her day job at Antwerp University Hospital: “We moved in three weeks ago,” she says, barely out of breath. Tim Decock, dressed casually in jeans and a fashionable shirt , laughs: “But we’ve already sorted the coffee machine.”

A lymph center rather than a lymph clinic

Physiotherapist Tim Decock.
Physiotherapist Tim Decock.

Tim Decock and Dr. Fias haven’t had much time to catch up over coffee during the last three weeks. Although the “lymph center” appears sparsely furnished from the outside, its objectives are already clearly formed – and the center has some serious work ahead. But the cheerful colleagues seem to be enjoying the journey, in spite of the late hour. “We’ve finally been able to realize our dream,” says Dr. Fias. It is clear from her words that she truly believes in their cause. “We want to create a central point for lymphedema patients to put an end to the cycle of being passed from therapist to therapist ,” says the physician. “Patients already have enough to worry about with their disease alone.” The physiotherapist continues: “We called our venture the ‘lymph center’ for a good reason. We don’t want it to sound like an expensive private clinic. This lowers the barriers for patients to access our service. Any patient can come here and will pay the same as they would pay in a normal practice or hospital.”

Extended network of therapists

The lymph center has one particular unique feature that patients will only encounter here: they will meet therapists and specialists from a wide range of disciplines, who usually only work in large university hospitals, such as the hospital in Antwerp. Alongside Tim Decock and Dr. Fias, two medical product specialists are employed in the lymph center team; they specialize in a range of disciplines, including the treatment of patients suffering from lymphedemas with challenging care needs. In such circumstances, precise measurement of the affected area of the body is crucial. In addition to the core team of physiotherapist/physician/medical product specialists, the center also employs a psychotherapist , a nutritionist and venous ulcer nurses.

Flat-knit technology medical compression stockings

Ensuring that patients have the information they need is particularly important to Dr. Lore Fias.
Ensuring that patients have the information they need is particularly important to Dr. Lore Fias.

It is a central contact point for patients, employs therapists from various disciplines, and offers a number of treatment rooms – but the lymph center is more than the sum of its parts. “We want to have an impact on the wider world,” emphasizes Tim Decock. “We want to inform. There are still far too many serious issues in our field.” One example is compression stocking treatment in the second phase of therapy. In the treatment of lymphedema, decongestion therapy is widely used as the first phase of treatment. A compression bandage, applied using a special wrapping technique, exerts pressure on tissues and muscles. It supports decongestion, stimulates lymph drainage, and prevents the tissue fluids flowing back into the affected parts of the body. MLDV, as practiced by Tim Decock, is also part of decongestion therapy. In the second phase of treatment , the patient receives special compression stockings designed to maintain the effect of the decongestion treatment. These products – used on arms, hands, legs and toes – are individually manufactured using flat-knit technology. Flat-knit compression products can be adapted for a perfect anatomical fit. The fabric exerts a high working pressure, which means that flat-knit products put more pressure on the tissue than circular-knit variants. For this reason, they are the preferred method of compression treatment in cases of lipedema and lymphedema. However, the success of the treatment depends on the product being worn correctly – and, in reality, this is unfortunately often not the case.

Bizarre stocking fashions

A picture often speaks a thousand words – so Dr. Fias turns her laptop so that everyone at the table can see the screen. The image shows a leg with the loose edge of a rolled-up compression stocking hanging just above the knee. The thigh is virtually strangulated, and the bizarre image is more reminiscent of frilly Baroque-style stockings than modern lymphedema therapy. “We see cases like this time and time again,” says the physician with concern. “Patients are often left completely to their own devices before the product is even put on.” Information, or “self-management”, as Dr. Fias calls it , is an essential component of the treatment. “When a patient leaves us, that patient needs to know what phase of treatment he is in and what the next steps are.”

“We’re even stronger together”

Antwerp’s lymph center would not be a true “center” if it did not play host to one final type of meeting: meetings between patients. Patients use the center to chat about things that even experienced therapists and lecturers like Tim Decock simply cannot understand: “I know what kind of additional treatments women who have had breast cancer surgery often have to go through,” says the physiotherapist. “But I can’t speak from my own experience about how it feels. The only people who can do that are other patients who have been through radiotherapy, for example, themselves.” These kinds of exchanges are part of the reason why Dr. Fias and Tim Decock are convinced of the need for the center. “We have no other option but to succeed,” they say with confidence. “The establishment of a place like this is long overdue.” Both partners are continuing to treat patients in their own practices too. But the physiotherapist and physician are already noticing a difference: “We’re even stronger together.” 

Pictures: Tim Decock, Stefan Durstewitz

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