Posted on Leave a comment

Ep. 70 – POWER Lymphatics 2020 Recap

Way back before stay at home was a thing, I had a blast at the POWER Lymphatics conference! The speakers were incredible with lots of information that has already been changing my lymphedema practice. In today’s episode, I’m recapping my time at the conference, what I’ve learned, & how it’s already guiding me to improve my patient treatments.

Lymphedema examination & treatment:

Lymphedema is not rare. There are ~5 million diagnosed in the United States.

There are some exciting tools coming out hopefully later this year for the assessment of external head & neck lymphedema.

Risk reduction practices for lymphedema are not obsolete. People are still undergoing procedures that increase their risk & are not being appropriately educated until after they develop lymphedema.

Gold standard for treating lymphedema is still to start with 5x/week.

When bandaging, there are many different ways to positively affect the person’s swelling & fibrosis. Abdominal binders for lobules, sustained holds for fibrosis, so many things I hadn’t heard about until this conference.

Regarding lymphedema treatment plans of care:

  • Talk $ on the first day.
  • Don’t rely on caregiver/family support.
  • Garment day isn’t last day of PT.
  • Use sharp (dull) test.

Other lymphatic disorders:

Similar to lymphedema, lipedema is not rare. However, the diagnosis of lipedema is. I knew lipedema was a thing, but after this conference, I’m starting to see more people in my community who probably have it & may not know it. It commonly takes women years and multiple specialists to finally a get a diagnosis of lipedema, which causes frustration, anxiety, & depression for many of these patients.

Conferencing as a whole:

Teleconferencing or calling in to a conference is going to be bigger & bigger for the rest of our lives. This conference took place right before a lot of places started implementing stay-at-home orders, but some of the presenters were affiliated with larger universities & medical systems that already implemented them. A few of the presenters simply gave their presentations via Zoom, Skype, etc, & were available for questions to be emailed to them afterwards. While it would have been nice to meet the speakers in person, this was definitely a viable option to promote social distancing while still providing learning opportunities – something I see becoming more common in the next few years!

COVID-19

There is a lot going on right now. First of all, I am so proud of our profession for stepping up to do our part, whether that’s on the frontline working with patients or staying at home to help flatten the curve. If you need another person to talk to during this time, please know that I am here for you & my community. I would love to hear from you.

Posted on Leave a comment

Ep. 69 – PT & Cancer Survivor: Scott’s Perspective

Happy April everybody! April 1 marks the start of Testicular Cancer Awareness Month, & what a great way to start with an interview with Scott Capozza, a PT & testicular cancer survivor. Scott graciously agreed to share his story on TheOncoPT Podcast & how his diagnosis affected his journey through PT school (yes, you read that correctly), as an adult cancer survivor, & as a newly minted Board Certified Oncology Specialist PT.

6:45 Scott’s diagnosis & treatment journey

18:06 Fertility preservation

20:54 How Scott’s cancer diagnosis affected his life

27:03 Scott’s life now as an adult survivor

31:06 What PTs should know about working with these patients, from a PT & CA survivor

Scott’s Bio

Scott Capozza, PT, MSPT earned his degree from Ithaca College.  He has been the physical therapist for the Smilow Cancer Hospital Survivorship Clinic at Yale Cancer Center since its inception in 2006.  In this setting, he works in unison with a dietitian, social worker and physician assistant to address the concerns of adult cancer survivors as they transition into long term survivorship.  Through this collaborative team approach, common survivorship themes such as cancer-related fatigue and fear of recurrence are addressed. Scott also works as Yale New Haven Hospital’s first dedicated outpatient physical therapist in oncology rehabilitation.  Scott is among the first class of board-certified clinical specialists in oncologic physical therapy in the country and serves on several national committees within the American Physical Therapy Association’s Academy of Oncologic Physical Therapy. He has presented at the American Society of Clinical Oncology’s Cancer Survivorship Symposium on the benefits of oncology rehabilitation and exercise for all cancer survivors.

To contact Scott (including about the Connecticut Oncology SIG), you can email Scott at Scott.capozza@ynhh.org.

Find Scott on Twitter: @ScottCapozza

Posted on 2 Comments

Ep. 68 – Online resources for patients stuck at home – special COVID-19 episode!

If you’re like me, my patient load right now is dismal. This means my patients aren’t getting their needed therapy, & we’re going to have a lot of catch up to do once they start leaving their houses again. UNLESS, they can start doing things NOW to help ease functional decline they may be experiencing without your help.

Some of you may have access to Telehealth for your PT services, & that is AWESOME. YAS! Unfortunately, some of us don’t have access (YET) to this amazing platform to serve our patients, so I’ve thrown together a quick episode to discuss some of the amazing resources I’m learning that can help our patients from the comfort & safety of their own homes.

I will try to update this page as I learn of more resources. Know of others? Send them my way at theOncoPT@gmail.com!

Down Dog fitness apps

Corissa Decker (of episode 64) told me about Down Dog & their line of fitness apps. From now until April 1, their programs are free to use! Amazing! Their apps include Yoga, HIIT Workouts, Barre Workouts, 7 Minute Workout, & Yoga for Beginners. You can find them on the Apple store & Google Play.

YMCA Youtube videos

The YMCA has a collection of video workouts including yoga, barre, boot camp, & active older adults.

https://www.youtube.com/channel/UCOGt_IpceP_xQhhCMCrut_A

Orangetheory Fitness

Orangetheory Fitness – I’m a member at my local Orangetheory Fitness, which has recently closed due to COVID-19, but they’ve announced that they will have workouts available on their app. I’m not sure if you need to be a member to access them, but you’ll have to check it out!

Cancer Rehab & Integrative Medicine

Dr. Angela Wicker-Ramos (Episode 13) owns Cancer Rehab & Integrative Medicine, located in Austin, Texas. They are now hosting their group classes entirely online, which your patients can find here: http://www.cancerrehabaustin.com/news. New classes will be uploaded as they happen, so check back frequently!

Lymphedema Physio

Dr. Andrea Leifner is offering 100 FREE online & virtual visits through May 15, 2020 for patients who have lymphedema to check in with a provider if they can’t get in to see their regular lymphedema therapist during this time. Click here for the link & discount code.

Self-MLD Youtube playlist

I found this link on one of the Facebook groups I’m in. It includes many videos of self-manual lymph drainage for arms, legs, & trunk.

https://www.youtube.com/playlist?list=PLPpxa6qxQL045yDyUjYiGExrNVR0EqjP6&fbclid=IwAR0NKWLdPjUy9h3MwwWpYfSX0F6ep-j4OYnMkNgVEgV2kzHfmKwGbVXNU-g

Know of more cool resources?

Please let me know! I’ll update the show notes here with more info as you send it in!

Posted on Leave a comment

Ep. 67 – What to know about Lung Cancer

Disclaimer: I didn’t plan for this episode (regarding respiratory issues) to coincide with COVID-19 being the news headlines. I actually planned this episode a few months ago. But, c’est la vie, & here we are.

In today’s episode, I’m discussing Lung Cancer, common treatments, & how PT can help throughout the entire spectrum of lung cancer care, from diagnosis to end-of-life. I’ve listed my references at the bottom of the show notes, & they were so helpful – I would definitely add them to your library to review!

1:04 Epidemiology of Lung Cancer

2:44 Risk factors for developing Lung Cancer

5:26 Lung Cancer Staging

6:51 Non-Small Cell Lung Cancer (NSCLC)

10:46 Small Cell Lung Cancer (SCLC)

13:23 Lung Cancer Treatments

18:14 Where does PT come in with all this?

References

  1. Lemjabbar-Alaoui H et al.  Lung cancer: biology and treatment options.  Biochim Biophys Acta.  2015 December; 1856(2): 189-210.  doi: 10.1016/j.bbcan.2015.08.002.
  2. Lung Cancer Guide: What You Need to Know. American Cancer Society. https://www.cancer.org/cancer/lung-cancer.html. Accessed March 16, 2020.
  3. Granger CL.  Physiotherapy management of lung cancer.  (2016).  Journal of Physiotherapy.  62: 60-67.  doi: 10.1016/j.jphys.2016.02.010
Posted on Leave a comment

Ep. 66 – Gynecological CA & Pelvic Floor PT with Beth Hoag, PT – part 2

We’re back with part 2 of Beth’s interview about gynecological cancer, its treatments, & how the pelvic floor is affected. Plus Beth’s recommendations on products & strategies for your patients!

Beth’s Bio

Beth obtained her Masters of Science in Physiotherapy from McMaster University, Canada in 2005.  Prior to this she obtained a Bachelor of Education from the University of Ottawa, Canada and a Bachelor of Arts from the University of Western Ontario, Canada. She also has an extensive background working in the fitness industry. 

Beth has worked in private practice for her entire career, beginning with a strong foundation in orthopaedics. Since 2008 she has been integrating cancer rehabilitation into her practice, which is her passion. Beth’s interest working in cancer rehabilitation stemmed from growing up with a mother who was diagnosed with metastatic breast cancer at a young age. As a physiotherapist, Beth quickly began to appreciate how her unique skill set could help people throughout their cancer experience. 

In a time where cancer rehabilitation was still in its infancy, formal training was limited.  Beth’s ongoing learning in cancer rehabilitation has been through formal oncology courses and conferences, CDT training, ongoing reading and independent research, and clinical experience. It is through these methods that Beth has become an experienced and knowledgeable cancer rehabilitation physiotherapist. In 2015 she began her own home-based physiotherapy practice, focused primarily on cancer rehabilitation. She uses an integrative approach to address the individual needs of each and every patient.

In the last 4 years, Beth has become very interested in pelvic health after cancer.  After pursuing her pelvic health training over 3 years ago, she now combines her extensive oncology experience with her patients’ unique pelvic health needs.  Whether it be addressing symptoms associated with the onset of menopause (caused by cancer treatment) or the more complex needs related to pelvic radiation and surgery, Beth is passionate about helping her patients.

Beth has become a strong advocate for cancer rehabilitation, including pelvic physiotherapy. She has recently been interviewed by a local newspaper and has been providing educational talks in her region to help raise awareness that cancer rehabilitation can help.

0:38 – Jumping right back in with radiation & side effects

4:11 Intraperitoneal chemotherapy (IP chemo)

6:44 How can PT help these patients?

Recommendations from Beth

Lube: should be paraben-free.

Based on 2012 WHO recommendations: pH 3.5 – 4.5 Osmolality <1200 mOsm/kg.

Lubricants:- found this one which is great for your personal knowledge:  https://www.womensvoices.org/wp-content/uploads/2017/02/lubricants_factsheet_final.pdf

Good summary of different types of lubes and their pH/Osmolality: https://www.womensvoices.org/osmolality-ph-properties-commercial-lubricants/

Beth recommends: Yes OB or Yes WB, Good Clean Love, Slippery Stuff

U.S. Pelvic Floor PT Locator


For Part 1 of my interview with Beth, listen here.