Tell Us About Yourself

I am a lympho-maniac. OK…perhaps better said, I am someone who is passionate about raising awareness of the importance of assessing and addressing the impairment of the lymphatics as it relates to chronic edema states, chronic non-healing wounds, and functional impairments. Lymphatics are REALLY important. We are only at the tip of the iceberg in regard to understanding the lymphatic system, in particular, the impact of lymphatic function as it relates to chronic non-healing. Specifically, I am referring to the power of compression (I like to call it Positive Pressure Wound Therapy, or PPWT) in stimulating the lymphatic system and other cellular structures. Harnessing the power of compression can not only reduce swelling, but also heal wounds, reduce pain, and improve function. Compression is magical when it is applied correctly and there is so much more to learn.

What was your path to wound care?

By degree and training, I am a physical therapist currently working in a small, hospital-based outpatient physical therapy department in rural NC. My path to wound care started in Philadelphia over 20 years ago when I picked up a second job working with the wound care team in an acute care setting of a large urban hospital on weekends. I was hooked from day one! The ability to work side by side with my medical colleagues—to make a difference in these acutely ill patients—was energizing. But it was during my advanced certification training in lymphedema that I had an epiphany! During a class where we were being instructed on trophic changes consistent with lymphatic impairment I realized that all my patients with chronic non-healing wounds had lymphatic impairments. By incorporating basic lymphatic principals into treatment, adding in different compression options, and focusing on mobility in addition to the basic wound care, my patients were getting better quicker! I was hooked.

What’s the most challenge part of your job?

The dogmas and myths surrounding compression and fear have presented challenges. On a daily basis, clinicians will say they want to use compression BUT the patient has CHF or ARF or PAD or cellulitis, etc. This hesitancy comes despite the evidence in the literature that clearly documents the benefit of appropriately applied compression—even in patients they are currently denying compression.

Up until the last five years, the utilization of compression has been passed down in very rigid, structured ‘box.’ As such, when the proverbial round patient doesn’t fit into the square box then ‘oh well, no compression for you!’ Even though we are taught to tailor our treatments to match our patients (and not the other way around), I find this to not always be the case with compression applications. Why? I would venture to guess that it is fear. Clinicians are afraid to use compression because they lack the understanding and don’t know where to get the information…or perhaps they’ve had a negative experience in the past.

This has become my passion…my purpose. My goal is to study the science of compression, share my findings with both colleagues and patients, and ignite in others a passion for finding evidence-based, creative way to incorporate compression into their treatment regimens. I want to fan the flames of the #CompressionRevolution.

How are you helping to change the field of wound care?

My purpose involves 3 aspects: Study, Share, and Ignite.

STUDY – Currently I am pursuing my PhD at Nova Southeastern University looking at the impact of an alternation compression profile. My hopes are that this work will provide a glimpse into the biophysical impacts of texture on wound healing.

SHARE – I love to talk and teach about compression, and I jump at every opportunity to speak with other clinicians about how to incorporate the basics of compression. The compression selection algorithm that I co-wrote with my colleague Robyn Bjork (S.T.R.I.D.E. Professional Guide to Compression Garment Selection for the Lower Extremity | Journal of Wound Care (magonlinelibrary.com) was the initial match to light the compression revolution—challenging clinicians to take a fresh look at compression selection. Furthermore, I have had the opportunity to speak at numerous local, national and international wound conferences/events, sharing my experience with compression.

IGNITE – Through all these opportunities, it is my hope that my original work will add to the science of compression, and that by sharing the findings as well as my experience, I can be the match that will ignite a passion in wound care specialists all over the world to take another look at compression modalities.

What does being a Difference Maker mean to you?

More than anything, it means having a platform to elevate the conversation of compression. Hopefully, clinicians will take the opportunity to learn more about S.T.R.I.D.E.™, Compression Certified Specialist (CCS) training, and lymphedema certification (CLT) and critically evaluate their own knowledge about the compression products they are using and ask, ‘Is there something different that would work better?’ It would be great if clinicians would reach out to their compression manufacture and demand the research on the new compression products coming on the market. This, combined with additional training utilizing the compression currently available, would be a huge step in the right direction. Being named a ‘Difference Maker’ allows me to continue to beat the drum that compression works…even from my tiny town in NC!

What advice would you give someone pursuing wound care?

Go for it…it is life changing! You won’t regret your decision. I have never met anyone who switched over to wound care and then left by choice. I would also suggest that you never get too comfortable. There is always something more to learn. Learning is an active process which you have to purposefully do. Look beyond the tag lines and flashy new products and demand the research. Challenge yourself to stay up to date on not just new products, but also the evidence to support your current practice. And finally, don’t forget you can’t do it all by yourself. Wound care is a team sport. The best wound programs are multi-disciplinary. Find ways to work with your colleagues and embrace collaboration.

Tell us a story that reminds you why you pursued your career?

It’s tough to pick just one. I am inspired when patients tell me that I have made a difference in their lives. I once had a patient who said ‘you saved my life.’ He had presented to the clinic for management of his leg wounds and swelling, however, he was clearly in cardiac overload. He had followed up with his provider but there had been a gap in his follow-up care and he was essentially overlooked. I made a connection with the patient through the evaluation—explaining to him why he was presenting the way he was— and convinced him to seek emergency care. I then followed up with him after he was stabilized to manage his lower extremity lymphedema and recalcitrant wounds. He still follows up every 6 months for new compression garments. With this patient, I was able to utilize every aspect of my degree and my specialty training. I was able to make a difference in his life. This is why I do what I do. I want to make a difference.

What’s something innovative you’ve done to advance the field of wound care?

I have incorporated the use of textured dressings under compression to optimize wound healing. I am leading the investigation of the impact of an alternating compression profile and the impact of compression application stiffness (not just dosage) on the therapeutic effectiveness of compression applications. This includes the fabrication of the different compression application/garments sewn from a lymphedema alternating pressure profile material (LAPP) and the comparative evaluation of 2 layer cohesive products currently available on the market.