Lymphovenous Canada: Treatment Programs in Alberta

Diane Martin of the Alberta Lymphedema Association met with the Minister of Health in March 2009 to discuss providing patients with primary lymphedema the same access to treatment as those who have lymphedema as a result of cancer. She also asked that the government that Complex Decongestive Treatment be provided for all patients with lymphedema in Alberta.

Says Martin, "The government agreed to pay for a one time assessment for primary patients. The primary patients will be sent to wound care treatment centres if they need it, and will also be able to take an exercise class paid for by the government if they want to. The Health Minister told us that he would have Alberta Health Service look into paying for primary patients as well." Congrats to Diane and the Alberta Lymphedema Association for their continuing work in this area!!

In early 2009 it was announced that the Tom Baker Cancer Centre in Calgary would be providing treatment for cancer patients in the hospital setting. A physiotherapist and occupational therapist were hired to take over treating cancer lymphedema patients using the protocol that the Cross Cancer Institute uses in Edmonton Alberta. The Centre indicated it would not, however, be providing treatment for patients with primary lymphedema because of space, money and staff constraints. The Tom Baker Centre will be permitting GP's to provide a referral note to enable patients with secondary lymphedema to get treatment at their centre, in addition to their surgeon or oncologist, as was previously the case.

Vodder trained massage therapists and other MLD specialists continue to provide treatment to persons with both secondary and primary lymphedema in the province. Notes Linda Moore Massage Therapy in Lethbridge, "Our clinic has been providing Dr. Vodder School International certified lymphedema management in Southern Alberta since November 2005. Treatment for primary and secondary lymphedema is by physician's referral only. Information and consultation regarding lymphedema and treatment may be obtained by appointment and without referral. Funding for treatment for cancer related lymphedema, on the basis of financial need, may be available through the Alberta Cancer Board on a case by case basis.

For more information on these program changes contact the Alberta Cancer Board Office at: (780) 412-6300 info@cancerboard.ab.ca or Calgary Regional Health at: (403) 943-1111.

Diane Martin can be contacted at: 55 Brookpark Crescent S.W., Calgary, Alberta T2W 2W6
e-mail: lymphnet@telus.net Tel: 403-281-9205 or 403-280-9467 Or visit their web site at: www.albertalymphedema.com

Funding for garments for Alberta children with lymphedema offered by ALA: The Alberta Lymphedema Association has funding to assist parents of children with lymphedema in Alberta to buy sleeves or leg garments. For more information contact the ALA at: www.albertalymphedema.com

The Alberta Aids for Daily Living (AADL) Program

The Alberta Aids for Daily Living (AADL) Program assists with the cost of graduated pressure stockings and sleeves for individuals with chronic lymphedema. Within existing resources AADL assists Albertans in maintaining their independence in their home or home –like setting, through the provision of funding for the purchase of medical equipment and/or supplies to meet the clients’ basic medically assessed needs.

The AADL program has a cost sharing policy, which requires the client to pay for 25% of the cost of the benefit(s) to a maximum contribution of $ 500 per family per benefit year (July 1 through June 30). A client may be exempt from cost sharing if he/she has a low income. The AADL Program has quantity limits and price maximums associated with the authorized benefits. Clients are provided with the option of up-grads at their individual expenses.

AADL assists with the cost of compression garments for individuals who have documented Chronic Venous Insufficiency (CVI) Class 2 or Class 3, or documented Chronic Lymphedema. AADL provides three ready-made compression garments or two custom garments to eligible clients every twelve months. Clients need to be assessed by their health care professional/AADL authorizer and require a physician’s prescription verifying that they had chronic lymphedema and which limb is affected. The Health care professional reduces any unresolved and/or investigates any unresolved edema prior to authorizing garments through AADL as AADL garments are to maintain the limb once the edema is resolved. AADL does not provide garments for active treatment.

The AADL Program does not assist with extremity pumps, however some regional health authorities in Alberta loan extremity pumps to clients.

For information on AADL coverage contact the Alberta Aids for Daily Living Branch visit their web site at: www.seniors.gov.ab.ca/AADL or contact them at:

Alberta Aids To Daily Living
Alberta Seniors and Community Support
10th Floor, Milner Building
10040 - 104 Street
Edmonton, Alberta, Canada T5J 0Z2
Telephone: Edmonton and area: 427-0731
Toll-free in Alberta: 310-0000, then 780-427-0731

CANCER CONTACTS:

Tom Baker Cancer Center Rehab Dept.
Lymphedema Management Program
2210-2nd St SW, Holy Cross Site,
Calgary, AB T2S 3C3
Phone: 403-476-2448

The Tom Baker Cancer Centre is the main cancer treatment centre for Southern Alberta, operating under the Alberta Cancer Board. The TBCC handles some 130,000 patient appointments per year and supports research across the full spectrum of cancer research activities.

Calgary Prostate Cancer Institute
#100, 1011 Glenmore Trail SW
Calgary, Alberta T2V 4R6
Telephone: (403) 212-8070
E-mail: pci@prostatecalgary.com

Willing to talk to men who develop lymphedema as a result of cancer treatment

Cross Cancer Institute
Northern Alberta Cancer Program
Lymphedema Management Program
11560 University Ave.
Edmonton, Alberta
CANADA T6G 1Z2
Telephone: (780) 432-8716
Janice Yurick, Coordinator, Rehabilitation Medicine
E-mail: janicey@cancerboard.ab.ca

Cross Cancer Institute's Lymphedema Management Program puts an emphasis on compression treatment with MLD provided to select/appropriate patients. The clinic can assess and provide guidance to clients on purchasing the appropriate compression garments and sleeves. Reid sleeves are provided on trial basis for assessment. Clients are also assessed for Legacy, MedAssist and Circaid sleeves.

The Institute's current treatment program is comprised of the following components:

1. initial assessment by a physical therapist. Some form of temporary compression garment provided where appropriate
2. appropriate lymphedema patients are referred to the lymphedema management program
3. patients receive 2 weeks of daily compression bandaging by a physical therapist
4. all patients are reviewed at 1 week for evaluation of treatment effect and to determine appropriate compression garment needs.
5. all patients attend a one hour lymphedema education class
6. all patients receive a final evaluation to determine compression therapy treatment effect. At this time a home maintenance program will be determined for the patient. This may include night-time bandaging, compression systems, self-massage and/or lymphedema exercises.
7. Upon final evaluation patients either:
   • continue with bandaging 2-3X/wk until custom garments arrive (this bandaging is done by a therapist assistant).
     
   • be discharged on home maintenance program
     
   • be referred for further treatment which may include MLD.
   • MLD may be indicated if:
     - there has been a poor response to compression therapy
     - trunk edema
     - pain management
     - chronic infections
     - other
     
8. At completion of active treatment, a 3 or 6 month follow-up appointment is scheduled.

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