Lymphedema Japan In a bid to improve health services for lymphedema care in the Philippines our PSVM members, Dr. Gertie Plameras and Dr Jasmin Melissa Bernardo, travelled to Japan to observe in Goto Lymphedema Clinic in Shinjuku, Tokyo with the help of Mr.Patrick Wagner, coordinator for international relations at Goto College Lymphedema Institute and director of the clinic and Member of the Board and Chief Instructor of the Medical Lymphedema Drainage Association of Japan, Mrs. Kayoko Sato who is one of the prime mover in lymphedema therapy and education in Japan. We were able to observe the actual process of diagnosis and treatment (lymphatic massage and bandaging) of patients and the meticulous documentation of progress through photo and measurement of limb sizes. Different kinds of garments, compressions and foams were also shown to use with the clinic itself developing some of them for ease and comfort of use of patients. There was also a short trip to Tokushima province, to visit a 20 bed or so hospital called Limbs Tokushima under the direct management and care of prominent Vascular Surgeon Dr. Ogawa who has for the past 10 years spear headed the diagnosis and surveillance by ultrasound as well as the treatment of chronic lymphedema in Japan. He has received hundreds of referrals from different parts of Japan, wherein
2 to 4 weeks of unique acute in patient treatment of lymphedema is done (manual lymphatic massage, multilayer bandaging, exercises and patient empowerment) followed lifelong regimen of self-care. Mrs Sato and Dr Ogawa are not only well known in Japan spear heading HMO coverage for lymphedema diagnosis and treatment but also well respected all over the world for their tireless effort in diagnosis and treatment of this rather orphan disease There was also a brief stop over in the Toko stockings factory. A state of the art facility in Tokushima that makes world class medical compression stockings, where temperature, humidity and even insect control is being done to ensure the highest standard in compression garments. They have off the shelf stockings as well as custom made garments for severe lymphedema cases. This trip emphasized the need to create our own registry for lymphedema and to perhaps facilitate a way to hold a training seminar for interested and qualified therapist for lymphedema (as of now we only have 3 practicing lymphedema massage therapist in the country) in either Metro Manila or Cebu. Their first lymphedema convention was held last September 24, 2016, attended by more than 300 lymphedema therapist and doctors. This sparked a hope in us to start our own initiative towards better diagnosis and management of lymphedema patients in our very own country.