The Jewish General Hospital Lymphedema Clinic, which began in April 2007 with funding from the JGH’s Weekend to End Breast Cancer, is the first hospital-based clinic in Montreal to offer both the evaluation and treatment of lymphedema secondary to cancer-related treatments. The clinic is run by Natasha Grant, Pht, a physiotherapist who has training in Combined Decongestive Therapy (Vodder). Dr. Bertha Fuchsman,a palliative care physician, is available as a consulting MD. Although the clinic sees predominantly breast cancer patients, patients with gynecological cancers, melanoma and other types of cancers are also seen.
The mandate of this program is to serve the oncology patients at the JGH, and referrals are made by the patient’s medical, surgical and/or radio-oncologist. The physiotherapist consults directly with the patient’s treating physician and primary nurse as well as with any other health care professional that may be needed (eg. social worker for psychosocial interventions). Patients undergo an initial evaluation with the physiotherapist after which they are seen every 3 months for follow-up. For those where intensive phase treatment is indicated based on circumferential measurements and physical impairment, they have 2 sessions per week of Combined Decongestive Therapy (CDT) for approximately 3-4 weeks. The maintenance phase is then initiated where the patient is encouraged to continue with skin care, an exercise program, and daily use of compression garments. There are a number of patients who are referred to the clinic for prophylaxis, and the appropriate risk-reduction practices are given as well as a prescription for a compression garment for all exercise, repetitive activities and air travel.
Regular communication is held with the patients’ respective CLSCs (Quebec community health care centre) in order to organize and relay information regarding their course of care. The JGH Hope & Cope Wellness Centre is a well-used resource for the program regarding patients’ training regime, and patients can be referred back to the clinic if any new symptoms arise. Natasha Grant has numerous contacts throughout the Quebec public and private system and is consulted frequently regarding a patients’ evolution with their lymphedema. More complex lymphedema cases/patients are referred to Dr. Anna Towers at the McGill University Health Centre (MUHC).
Patients are encouraged to participate in exercise groups offered by the community including Tai Chi/Qi Gong, Aqua-Lymphatic Therapy (ALT), and the Lebed method. Patients can pursue further CDT management in the private sector and a list of resources is published by the Lymphedema Association of Quebec.
Education and resources are also available as a risk reduction practice in cases where there is no development of lymphedema.
Since its inception, the clinic has grown and now follows over 200 patients. It currently functions 3 days per week (Wednesday-Friday, 9:00 am - 5:00 pm) with the possibility to expand to 5 days per week.
Segal Cancer Centre-Pav E-8th Floor
Natasha Grant, Pht
Tel: (514) 340-8222 ext. 5529; Fax: (514) 340-8727
**The JGH Lymphedema Clinic is open to all patients who are followed by an oncologist and/or a physician at the JGH and therefore will be referred to the clinic by their treating physician.**
Web site of the McGill Lymphedema Research Program.
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