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Foust, Wanda

Wanda Foust

Wife of 49 Years, GM Retiree and Combined Decongestive Therapy Patient

Gladwin, Michigan

“My arm is feeling really good. It took time and patience, but we were pleased with the results.”

She Keeps the Pressure On to Control Lymphedema

When Wanda Foust’s left arm and hand began to swell, she knew the problem was lymphedema, and she knew the solution was a special kind of therapy that took time and effort, but could produce good results.

Wanda isn’t sure what caused her lymphedema, but she thought it might be related to cancer treatment she had in 1973 and 1983, and her therapist confirmed that was the case.

“I’m a survivor of breast cancer, twice,” said the Gladwin resident. “By the grace of God, I’m still here at 75 years old. That’s pretty good.”

With the same spirit and determination that helped her beat cancer, Wanda went after the problem that made her fingers unable to grip and made her arm so swollen that it wouldn’t fit into the sleeve of some of her blouses. Since untreated lymphedema just gets worse, she knew she had to find help.

Wanda’s family physician in Gladwin, Marcelino Barreto, M.D., provided a referral for combined decongestive therapy. A friend recommended Physical Therapist Julie Nielsen, P.T., C.L.T., at MidMichigan Medical Center–Midland. “She told me if anyone could help me, it was Julie,” said Wanda.

Lymphedema results when trauma, radiation therapy or other problems affect the body’s lymphatic system, which is part of the circulatory system and an important part of our immune system. A clear fluid called lymph is produced in the bone marrow, lymph nodes, spleen and thymus, and the lymphatic system keeps the fluid moving toward the heart.

When the fluid can’t move through its usual channels, swelling results. Lymphedema can happen in any part of the body where the lymphatic system can’t function normally. Untreated lymphedema is chronic and progressive, with worsening swelling, pain, loss of function, potential skin breakdown and recurrent infections.

The idea behind combined decongestive therapy is to get the fluid back into circulation and help it find new pathways to keep moving where it needs to go. Doing so reduces swelling, stabilizes the problem, improves healing and restores the ability to do activities of daily life. Skin care, exercise and diet management are also part of the plan. More information about combined decongestive therapy can be found at

“Proper treatment can begin to produce results in as little as 24 hours,” Julie said, “but the patient and therapist must dedicate time to get the problem under control, usually three to six weeks depending on the needs of the individual patient.”

Patients need to have daily treatment and wear wrappings on the affected area 23 hours a day. Often a family member is taught how to do the massage and wrapping.

“Julie started the massage on my trunk, then my arm and fingers and back again, always massaging away from the swollen areas to more ‘open,’ non-swollen areas,” Wanda said. “Then she wrapped my fingers, hand and arm using gauze, foam wrap and bandages. It’s quite an art.”

Wanda had help from her husband, George, who went with her to Midland four days a week for six weeks of treatment and performed Wanda’s therapy at home three days a week.

“Julie took a video to help George remember what to do. I was a star and didn’t know it!” she said. Occasionally, wrapping was a challenge. “We worked at it, and sometimes we had to start over, but we did it.”

After a few days, Wanda noticed the swelling going down. “You could tell by the wrap, the bandages would just give way when you took them off,” she said.

Six weeks later, when the therapy was complete, Wanda was able to move, grip things more easily and wear clothing that had previously been too tight. Julie worked with a medical supplier to provide Wanda with well-fitting day and night compression garments as part of her home program to maintain the swelling reduction she had achieved.
“My arm is feeling really good. It took time and patience,” Wanda said, “but we were pleased with the results.”

Wanda said it’s clear that Julie is highly skilled and cares about her patients.

“She was a very affectionate and caring woman. She took her time and allowed the time for you,” Wanda said. “I heard about Julie from a friend, and now I’ve passed her name on to another friend who has lymphedema. When you get good results, you want to share it.”


If you experience swelling following surgery, ask your doctor for a referral to a physical therapist specializing in lymphedema therapy. To locate a therapist, call MidMichigan Health Line toll-free at (800) 999-3199.