Can you tell us a little bit about yourself?
John Jordi: My name is John Jordi. I am a lymphedema therapist but I have been in physical therapy for the past 30 years. I’ve been a lymphedema therapist for about the past 24 years. I’m a certified instructor for The Academy (of Lymphatic Studies). I’ve been a senior instructor there for a lot of years. I’ve done a lot of treatment over the years, all related to lymphedema at this point. Currently, I’m holding a job working in a vein clinic and also working as the clinical manager for Juzo USA.
What inspired you to become a physical therapist and work in the lymphedema field?
JJ: So physical therapy: I graduated from Minneapolis and just it was a great job fit for me. I was an athlete, I liked working with athletes. I got interested in wound care at some point and when I was working at the hospital here we were doing a lot of things with wounds that weren’t always working. Many times I had done wound care programs where they talked about fibrin issues and protein issues and a therapist had gone to a class specifically to treat this. I was so interested I became a CLT (certified lymphedema therapist) myself. What happened was I completely changed the wound care at the hospital to address veins and venus wounds and venus insufficiencies and chronic edemas in a very different way with amazing results. That just really inspired me to stay in the field, and since then I’ve continued to progress along doing multiple research projects with universities as well as becoming an instructor for the school I learned from.
What have you noticed in changes to how lymphedema has been treated over the year? What’s better? What’s the same?
JJ: Lymphedema, when I first started back in ‘99, things were really unknown, at least in my general area. What we had noticed is that the treatment had really moved quickly. We had 5 lymphedema programs in town within just a few short years and we saw a lot of really good outcomes and patients getting a lot of treatment. Things that are different now are that there are no big lymphedema programs any longer in my general area and we’re seeing a much smaller scale. I think that’s becoming a problem is that patients don’t always have a lot of places to go anymore because therapists don’t always have the interest or it’s just been really difficult. That’s one of the changes that’s not been great.
One of the big changes that happened a couple of weeks ago is with the advent of the lymphedema treatment act you know compression garments, that’s really been one of the hardest parts. Patients haven’t always had access to garments– if you’re on a fixed income, medicare– these are very expensive garments and they’re absolutely necessary. I tell therapists when I teach classes, “If you don’t end a patient in compression garments, you have not finished the job.” Patients need to end in a garment so that they feel like they have some level of normalcy and some ability to take charge of their own lymphedema issues. If you’re on medicare if you’re on fixed income a lot of these things become a problem. Now that this pass-through legislation has become official, there’s the potential that these patients could be getting garments and we could be seeing an increase in lymphedema programs because patients now can get treated and they can finish treatment appropriately.
What is a piece of advice you would give to someone going through treatment right now?
JJ: What I would tell any patient is if you’re going to start this, you need to be ready to finish and you need to be all the way in. Patients who just dip their toe into lymphedema treatment almost are always frustrated because they think they can do a little bit here, a little bit there and they’re gonna get better. The fact is, you don’t get better at all. You’re actually going to see yourself continue to get worse over time because lymphedema is unrelenting. It never stops progressing if you don’t do something about it. Constant compression and constant containment is really the key factor. You have to do your part. I remind many patients it’s like having diabetes. If you don’t manage diabetes it will manage you and there will be long-term consequences you may not always get to choose. Treat it now, treat it aggressively, and get a handle on this.
For a therapist, I would tell them to vet the patient well. Make sure that the patient is already ready and fully understands what the program is because therapists who let the patient drive the treatment program really end up doing a disservice to the patients because the patient doesn’t know what they don’t know. The therapist should be able to educate them during the evaluation to make sure the patient fully understands what they’re getting involved in so when they’re ready, they’re really ready. I make it akin to this– what physician would ever tell a patient, “We need to cut your knee off. We’re gonna replace it with metal and plastic inserts and put you back together. You’re gonna have a lot of discomfort and a lot of problems and that’s your total knee replacement.” Nobody begins with that. We know that there’s a lot of work to a knee replacement but what we focus on is the after-effects– the outcomes, the long-term independence that you’ll have from being free of the pain, the joint dysfunction, and all the other problems that come with knee arthritis. In lymphedema, we only focus on the problems, not on the long-term. That’s where we need to focus. If patients understand I will learn how to manage this myself, I will learn how I can be independent, and I will learn how I can get the better part of my life back. Yes, I’ll have to make changes but what we’re really after is for the patient to be able to have a new normal that they can find accessible and that’s the responsibility of a therapist to help educate that patient to understand it.
How do you work with Compression Care?
JJ: Why do I utilize a company like Compression Care? Well, one of the big reasons is that when I teach for the academy and when I go around the United States I work with different vendors, I work with different DME (durable medical equipment) companies, and I work with different Juzo reps. The territory managers bring in therapists who have problems and need solutions and not always are they tied to a good DME facility that can bill appropriately and get the products to a patient. There’s a lot of places that look like a variable desert without any coverage for products. These patients are still there.
What’s really nice is when we have a bigger company like Compression Care, they can bill throughout the United States and that’s a big deal to me. We like local, we appreciate utilizing places that are very close, but when we don’t have that as an option or when we don’t have facilities that know how to bill, specifically lymphedema products, appropriately, it’s nice to know that I’ve got a company like Compression Care that I can make the referral to and get it all done. I love the fact that they do it in a timely manner. I’m not waiting weeks or months to get products or even to get the authorizations. They respond right away whether it’s through fax, through email, or through a phone call. They’re always appropriate and they keep up with me so I appreciate making that happen whether I’m working here in my general area or when I’m out in the territories helping the therapists make better decisions on their patients to get the best outcomes for them.
At the end of the day, if a patient doesn’t end in compression garments, whether it’s a compression wrap, a circular knit, or a flat knit, they’re not getting the best outcomes. They’re going to swell back up. We want to make sure the patient’s getting the right daytime products and the right nighttime products and I really appreciate working with Compression Care and having certified fitters and clinicians on staff to work with me to get the best outcomes for my patients.
If you or a loved one is struggling with lymphedema, Compression Care is here to provide support. Call us at (615) 583-2273 and let us know how we can help!