FAQs

Every day, about 20 liters of plasma (the liquid part of your blood) flow out of tiny pores in the thin walls of your capillaries. Imagine water seeping out of a sponge. Where does this liquid go? It delivers oxygen and nutrients to the tissues surrounding each capillary. The tissues hungrily soak up all the nutrients while leaving behind waste (like a kid who finishes their food but leaves behind a pile of sticky napkins).

The plasma doesn't mind cleaning up the mess — it picks up the waste and then returns to your bloodstream the same way it came, by flowing back through the pores in your capillary walls. Each day, about 17 liters of plasma return to your bloodstream in this way. Since 20 liters initially flowed out of your capillary walls, that means 3 liters are still roaming around in your body's tissues.

That's where your lymphatic system steps in. Tiny lymphatic capillaries pick up this remaining fluid from your tissues. The fluid changed its name during its journey: it's called lymph. Your lymphatic capillaries move the lymph into larger tubes called lymphatic vessels.

These vessels keep the lymph moving until it ultimately reaches one of two major ducts in your upper chest. These are called your right lymphatic duct and thoracic duct, and they're a bit like highway on-ramps. They merge into large veins called your subclavian veins and empty the lymph into them. From there, your lymph reenters your bloodstream and can flow through your body again.

A good analogy for the lymph system and how inflammation affects the lymph system:

• Imagine your lymph system as a bathtub shower.
• Your lymph fluid is shower water.
• Your body is the tub.
• Your lymph nodes are the drain (imagine a hair catcher on top of the drain so lots of little holes).
• In a normal healthy lymph system - water from the shower comes out as fast as it goes down the drain leaving no standing water behind.

Now imagine an acute injury or trauma like a sprained ankle (in the health field, acute means there is a beginning and an end) — this looks like letting the shower water run, but also turning on the bathtub water at the same time. The amount of time and intensity at which the bathtub water turns on varies based on the acute trauma, but it is more than normal. Now there is standing water, but hopefully and usually eventually, your body's lymph nodes (the bathtub drains) can move this excess fluid through, leaving no standing water after a couple of days. Sometimes this doesn't happen, and that's where we step in - to help move along that excess fluid back into the drain!

Now imagine chronic inflammation, like in the case of an autoimmune disease.

This leaves a constant amount of standing water in the bathtub because this amount is always larger than the amount of shower water (the amount your body is programmed to manage), and your drains can only handle the amount of water produced from the shower water. Our job is not to let that standing water accumulate on the bottom of the bathtub, but to chip away at it each session to get your body in a more manageable, functional, and optimal place.

Now imagine lymphedema, which can be from lymph node removal, trauma, radiation, or scar tissue. This is like taking away some of the drains. There is no excess water, just not enough drains to allow the water to go down the drain without any issues.

What causes excess inflammation?

Lymph is a by-product of blood flow. With inflammation, we have more blood flow and then more lymph. Therefore, inflammation affects the lymphatic system.

Possible causes of inflammation (although it is different for everyone):

• Diet: eating foods that create an inflammatory/allergic response to, or eating too little/too much.
• Exercise: too little or too much.
• Hormone imbalance.
• Genetics: having a predisposition to something like an autoimmune disease.
• Acute or chronic stress.
• High Cortisol levels (caused often by chronic stress).
• Environment: allergens or sensitivities.
• Acute trauma.

We look at all of the above factors that could play a role in excess inflammation and then assign them as either a pebble, a rock, or a boulder, and decide which variables are contributing to your particular situation and which variables can be changed, and which cannot.

We imagine a cylindrical vase filled halfway with water, and start adding in your inflammatory factors into the vase. We begin to SEE/FEEL symptoms of excess inflammation when the vase overflows.

For example, if you have an autoimmune disease (this would be a boulder), have a sensitivity to gluten (pebble), and a close relative just passed away (rock), this could be enough to tip the water over the edge. This is where the interdisciplinary, holistic approach to patient care comes in. We often make referrals to other professionals who can help address your changeable pebbles, rocks, and boulders, so we can focus on what we specialize in, which is to treat the overflow of inflammation (i.e., lymphatic fluid) that we see.

Your practitioner will require you to fill out a health history form. If you are a new patient, please be sure to fill out your intake form online in advance by going to the INTAKE FORM section of the menu and completing the appropriate intake form. This ensures beginning the session on time.

Your practitioner will begin by doing a comprehensive subjective to understand and establish what your concerns are, to know about any health conditions needing to be addressed, and to determine if manual lymphatic drainage/scar tissue work is appropriate for you. The practitioner may perform certain assessments and testing to evaluate your condition.

Your practitioner will leave the treatment room for you to have privacy while getting ready for your session. They will knock on the door before they come in. Once they are in the room, they will make any necessary adjustments for your comfort before beginning the session. Feel free to ask any questions that may come up for you.

At the end of the session, feel free to take a moment on the table to stretch and "come back into your body". Once you are up and dressed, a conversation about your session will take place in your treatment room and any questions you may have or suggestions from the practitioner can be discussed at this time.

Keep well hydrated for the 24 hours leading up to your session to ensure the best results while minimizing your risk for feeling crummy after the session. Avoid eating less than one hour before your session.

Try to plan time after the session where you can fully embrace the relaxation provided during the session. Avoid doing a super heavy workout or very strenuous activity 24 hours leading up to your session, as this may increase some inflammation in your body and not allow us to determine a baseline for your inflammation that we are feeling in your body at time of session.

Depending on the primary technique your practitioner uses, you may or may not need to fully undress. For a full body manual lymphatic massage, most people undress completely. However, you may choose to wear undergarments. Your practitioner will give you privacy to undress, and you will be covered with a sheet and blanket at all times except the area being worked on.

Manual lymphatic drainage is best performed while the patient is fully undressed, as restrictive clothing and elastic bands can obstruct good lymphatic flow. That said, you will always be covered with a sheet or towel during the session.

Massage and MLD can be profoundly relaxing, affecting all your bodies systems. Give yourself a moment to reorient before slowly getting up. After an initial period of feeling slowed down, people often experience an increase in energy that can last for several days.

With Manual Lymphatic Drainage, it's not uncommon for people to feel a number of symptoms associated with moving excess inflammation, which can look like a feeling of general malaise, such as headache, or feeling tired. Sometimes you may not feel dramatic results right away. Watch for changes over the following days, such as pain relief, decreased swelling, increased mobility, or reduced stress.

Because lymphatic fluid is released through urination, it's not uncommon for people to find themselves in the bathroom more frequently after a MLD appointment.

Scar tissue mobilization/remodeling can sometimes be painful for a number of reasons — one is significant scar tissue, as is often seen after surgery or a big trauma needs more aggressive remodeling as the scar tissue is often large and can be deep. If done too gently, we will not get the same results and likely will not prevent adhesions from forming.

Two, scars can often entrap superficial or deep nerves. Mobilizing the scar tissue helps with freeing up the nerves, but it can feel very sharp or have a burning sensation while performing the scar tissue work. This is normal and needs to be worked through in order to untangle the nerve from the scar tissue.

WE WILL NEVER GO PAST YOUR COMFORT LEVEL AT LSOM, BUT WE WILL EDUCATE YOU ABOUT WHAT IS MOST BENEFICIAL FOR YOU AND ENCOURAGE YOU TO MOVE PAST SOME DISCOMFORT WHILE PERFORMING SCAR TISSUE WORK. That said, we can absolutely do more gentle scar tissue work at the first few sessions to build comfort and trust while working up to deeper work in future sessions.

No. Receiving manual lymphatic drainage or scar tissue work while battling a cold or influenza is never a good idea. Not only can you easily spread illness to your practitioner (who is seeing several other clients per day), but you can also exacerbate your symptoms by receiving manual work.

Also, if you are currently taking antibiotics for an infection, we ask that you are halfway through your antibiotic course and no longer showing any signs of infection. If we are unsure if the infection is cleared, we may require consent/permission from your doctor to proceed with a session.

Please note that although the clinic has a strict cancellation policy, we will never charge you for not coming in due to illness.

If you do come in while ill, your therapist may choose to reschedule your session. Know that this is for your well-being and the health of our therapists and other patients.

We use the honor code in regards to our no-charge policy with late cancellations due to illness, so please do not abuse this. Our practitioners are busy, and their time is valued.

Lymphatic Specialists of Madison exists because manual lymphatic drainage is often not covered by medical insurance. If it is, only for certain conditions and only for a few sessions with the work under insurance, mainly being education/exercise-based. In contrast, we are able to offer one-on-one, hour-long sessions of hands-on work for anyone with inflammatory acute or chronic conditions.

All appointments must be canceled with at least 24 hours' notice, except in cases of illness. Cancellations made with less than 24 hours' notice (for reasons other than illness) will incur a fee equal to 100% of the appointment cost. In such cases, an invoice will be issued within 24 hours, and payment is expected within 24 hours of receipt. We appreciate your understanding in this matter.

While it is not an obligation to give your practitioner a gratuity, it is always appreciated. Gratuities can be given at the time of payment or, if you care to be more discrete, can be left in the treatment room for your practitioner after the session.

If you looking for an different way to show appreciation for your practitioner, leaving a positive review online or referring a friend to our clinic is a great alternative to tipping.