Laser Therapy

[Chuck]

In November 2006, the US FDA approved the first device for laser therapy of post-mastectomy lymphedema. See Rian Corp (http://www.riancorp.com) for details.

I'm curious to know if anyone has experience using this device as a patient or therapist.

[RaftingRita]

I visited the RianCorp web site and read the announcement of the “FDA approved the use of the RianCorp LTU-904 low-level laser device for use in the treatment of secondary lymphedema following the treatment of breast cancer.” This is exciting news --and it makes me uneasy.

On the RianCorp site I also read the study by Dr. Piller and his team that led to this approval. It is based on the treatment of only 67 women over a period of six-weeks.

RianCorp is straight forward in specifying that this approval is only for one specific device. My concern is that other “red light products” might "imply" that they too are approved for this use.

Another concern is the adventuresome use of this technique in ways and on body areas where it has not yet been proven to be safe or effective.

Like every other woman with secondary lymphedema after breast cancer, I’ll be watching this development closely, with caution, and a lot of hope.

Rita

[Deejay]

I attended a seminar given by the CEO of the RianCorp. It was all about the lowlight laser that has been FDA approved for treatment of post-mastectomy lymphodema. I live in NYC---Manhattan and am VERY interested in getting treatment with this laser.
Does anyone know of a PT or OT, in Manhattan,who is offering this service?
How do we get the CPT codes and insurance companies up to speed on this new treatment?
I understand it has helped a number of people--has anyone been treated with it?

[k2shine]

Hey is the CEO of raincorp a Doctor? Laser and lymphedema. I tried to contact the Doctor at Mcgee women's hopsital here in Pittsburgh his reply was make appt to see me. I already see someone from that practice . So go figure. I'm tired of chasing Doctors and wise butt opinions that dont get us anywhere

[aangel]

I am the CEO of Riancorp and I am happy to answer any laser questions.
Yes, we treated 72 women, but we treated them for 6 weeks over 4 months and then had 2-3 months follow-up. Very few lymphedema treatments have this level of research, hardly any have follow-up.
There are many products on the market with NO research support at all.
I am not a doctor.
Our distributor www.biohorizonmedical.com has a list of every therapist in the US who has a laser unit on their website.
Regards
Ann Angel

[aangel]

Ann Angel again.

I also want to comment about a couple of other things that have been mentioned.

Re insurance for laser. I have had many discussions about this and basically I have been told that we will have to do another trial with cost/benefit analysis etc. Estimates of $2 mil have been given to me. The trial will take two years and then another two years before a CPT code gets listed.

I'm thinking spending all that time and money (that will have to be passed on to the product cost) maybe just filling the pockets of various consultants and the patients still miss out.

Im not living in the US, so my understanding of your health system is limited. The information that I have is that insurers are REDUCING the number of lymphedema treatments that are covered, so even if we did the trial etc, the coverage might be very poor.

The laser is $3,995. There are CPT codes, but they are not reimbursable. Some therapists are providing laser as part of their treatment. Some are charging a small out of pocket fee.

I don't know the answer. But given that some insurers do not cover garments or bandages it seems that getting coverage for laser is a difficult ask.

Also, there was a comment about other "red light"products using our FDA clearance and trial to sell products that are not the same. This is happening and I suggest that anyone who is offered another product should do some checking. I'm happy to help.

For me, I want to see more lasers used for lymphedema. If I think that another product is probably going to be effective, I will tell you. Lasers for lymphedema do not produce any heat. If you are offered a product that heats tissue I would definately seek more information.

Ann
Anngel

[Deejay]

To Ann Angel of RianCorp

I attended your NYC seminar at Share offices. I developed lymphedema about 7 wks ago---my swelling at this point has been treated once with 10 days of MDT and the layered wrapping. I am presently wearing a customcompression sleeve.
Do you sell the laser to private individuals? If so, how does one learn to use it? I have spoken with my insurance co. and they have said that with the proper paperwork, my policy would cover the laser. At this point, no one in Manhattan is using it for treatment.
Do you think I can safely use it myself??

[aangel]

We can provide lasers to individuals, but you do need a prescription from your doctor (I have an example that they can sign). The laser is easy and safe to use at home, but you probably still need to maintain contact with your therapist. You still need to get your arm and garments checked to make sure that your lymphedema is not getting worse etc. Many patients have their own laser, but I dont want to promote it as the "cure" for your lymphedema. If an individual wants to try a laser (and gets a prescription) you can have the laser for up to a month and return it if you dont think that it is working for you.

[k2shine]

I would like to know how the laser works before I go and ask my doctor for a RX to get one. You have a website that shows how it works etc? Including how to contact you via email? Let me know please. I'm looking for relief of my breast lymphedema. My garments are all new etc. Let me know thanks

[aangel]

Kim, please contact me at aangel@riancorp.com. for the information that you want.

[zoetman]

what about the use of laser therapy for postsurgical lymphedema -- I had a frozen shoulder and impingement syndrome surgery two years ago which did not heal right, and now I have lymphedema. will the laser therapy work for this? Also, is there only one kind of laser that is useful in this situation -- the RianCorp? Or are other people using other kinds of lasers? Thank you

[Bahons2]

Hi

I am a private individual who has one of these lasers. I find it helpful, not only with lymphoedema itself, but also with pain relief.

I've also been treated with a different type (Class III) of laser, in Australia, with good results.

[zoetman]

What kind of doctor/therapist do you go to or did you buy your own laser?

[Bahons2]

Hi

At the moment I use the laser, which I bought myself.

I've also just finished a course of 15 MLD (Manual Lymphatic Drainage) sessions with an MLD qualified physio which has helped as well.

I think that doctors specialising in lymphoedema are like hen's teeth. I've been seen by specialist nurses on occasions, but most of the time I've had to actively seek out help for myself from accredited therapists.

The laser's not a cure, but I find it helps, particularly with the added burden of tennis elbow.

Hope this helps - any more questions, just ask away!

[zoetman]

May I ask where you got the lazer and how much it cost? I really appreciate your sharing your situation with me. Do you have tendinitis in the elbow? I have bicep tendinitis. Thanks

[Bahons2]

Hi

My laser is the RianCorp one mentioned in this thread. I got it bymail order from RianCorp to France, where I live.

I think it cost me about, I imagine, the equivalent of between $2,500 and $3,000 US, though I think the price way have gone up since.

I've been told I've got both tennis and golfer's elbow as well as lymphoedema, in fact, so tendinitis in the elbow and sometimes it flares up in the bicep as well.

Hope this info is of use.

[zoetman]

Thanks for the info. Can you do anything with your arm? I am a writer and am right handed so this situation has affected me terribly. I have voice activated software, but still just keep my arm up with on a pillow when I write sometimes too much for me. And I have to constantly monitor how much I'm doing and how stressed out I'm getting. Sometimes I wonder if it's even worth it to try to write, but then if I don't write I get bored and depressed. Thanks for listening

[Cassie]

Hi!
I'm a writer too. My right hand is just about useless from LE, so I bought a right-hand-only keyboard called a Frog Pad (I think it's at www.FrogPad.com, or you can google it.) It was hard to adjust to -- back to Typing 101! But I knew it would take awhile and just kept reminding myself that you CAN teach an old dog new tricks. At least if the old dog hangs on to her sense of humor!

Anyhow, I'm back up to speed now and not straining my right hand or gnashing my teeth over the disability anymore. And the keypad is cool, too!

Onward!
Cassie

[Bahons2]

Hi there

I used to be a writer too! Hoping to go back to it one day. I'm left-handed and have LE in both arms, the worst is the left. The tennis/golfer's elbow is in the left arm, too - probably no coincidence.

As I mentioned in the other thread, the tennis elbow is coming under control - slowly - but I always mouse with my right arm. I have a gel wrist support, too, always support both arms on the desk and use a tennis elbow wrist support if it starts to flare up. And....it's a pain, I know, but I've found not overdoing things really helps. The laser seems to help with any deep nagging pain in my elbow.

It sounds as tho' your problem is more severe than mine - what help have you had so far?

[zoetman]

Totally not over doing things is the way to go from me! But that is so difficult with my personality: I am excessively driven and obsessive at the same time so I can't always "let go" when I need to. Because of this behavior, I tend to perpetuate both the lymphedema in the bicep tendinitis. I've been thinking a lot about this lyric in a Coldplay song that goes: and the hardest part is letting go, not taking part. That was the hardest part... this is totally the thing that I need to work on: pacing. But also with me, the least little anxiety or anticipation of something can set me off, even when I don't realize that I'm anxious or anticipatory. It's really a very difficult life. Prior to the surgery in 2006 which set this all off, I was a full-time writer and had finished a novel. Now, I can no longer sustain the rigors of novel writing. I have switched to writing picture books for children, and poetry.

As far as modalities I've tried, I've tried acupuncture, physical therapy, massage, trigger point therapy, massage for lumph drainage but they all flare up my bicep tendinitis. I'm hoping to find somebody who does laser work in this area because that would be non-touching, which is the thing that flares my arm up.

What do/did you write? Also where do you live in France? I'm quite a Francophile I have to admit. I once spoke French pretty fluently but that was a long time ago and I'm very rusty now. I stayed in Aix en Provence for three weeks in 91 and had a good tour of southern France. I loved it!

[Bahons2]

Yes, it's hard to change the habits of a lifetime as regards slowing down/not overdoing it, isn't it? I've found that not doing any one ask for too long helps,too, if you like keeping busy 10 mins ironing (or whatever!), 10 mins peeling potatoes, 20 mins computer then going for a walk - sort of varying the activity before fatigue and pain set in. It makes me a bit of a fidget and there's a trail of unfinished tasks round the house, but it's better than the distress I was in.

I think I'm correct in saying that acupuncture is not recomended in limbs affected by lymphoedema due to the risk of infection and associated complications.

I've also been treatd with a CLass III laser in Austalia at a specialist lymphoedema and physiotherapy clinic, which may interest you. Their website address is:

www.lympholaser.com.au

I live in Carcassonne now, in SW France (and the weather is terrible at the moment in case anyone is feeling envious!). I used to be a technical writer, although I've written a few other things as well. Not as glamorous as novels, but it kept the wolf from the door.

Any more questions, just ask away!