JoAnn Rovig's Blog

Since we are currently in the peak of cherry season it seems an appropriate time to talk about the pits.  This last weekend  at a 4^th of July party I had an opportunity to talk with a business owner and long-time family friend who cans 100 tons of cherries a year.  I just had to ask him what he does with the pits and was surprised to learn he uses them to surface the roads throughout his orchards.  Well I have to tell you he was quite surprised to learn we are using cherry pits in our JoViPak garments.

I know this sounds a little crazy, but when fibrosis gets to the “woody” stage, foam chips just don’t do the job.  We can thank Karen Ashforth, OTR/L,  CLT-LANA, from Dominican Hospital in Santa Cruz, CA for this idea.  We first tried buckwheat hulls which ended up in my garden.  They are a great mulch, but I was not happy with the way they splintered inside our garments, plus they will not hold up with repeated laundering.  Karen is not someone who gives up easily and wanted us to try cherry pits. She even found a company who sells cherry pits to hobbyists for microwaveable neck pillows.  Once she discovered how well these pits worked on her patients with long-standing fibrosis, she offered to do a clinical trial.  (You can access this information by going to our website, www.jovipak.com and clicking on the “What’s New” page.)

The first patient I tried one of these new JoViPitPaks® on was someone I had treated in my clinic 17 years ago.  Over the years she had maintained fairly well with daytime compression garments, but over time had developed  fibrosis at the base of her toes.  I took her  to the Northwest Lymphedema Center, where Lynn Fass, RN, CLT, does her consultations, and put the patient on the treatment table.  As we caught up on old times, I held one of the small crescent-shaped JoViPitPaks firmly over the problem area.  In about twenty minutes we checked and to both of our amazements the fibrosis was soft and pliable.  I gave her the pad and will always remember her parting words as she backed out the front door holding up her JoViPitPak,  “I just love this thing!”

JoViPitPak Axilla Pad

So we have all come to love JoViPitPaks, and just so you have an idea of what we are excited about, we are including a photo of the new axilla pad.  We are adamant, however, that anyone interested in using these products understand they are very aggressive, to be used under compression for very short periods of time under the supervision of a lymphedema therapist. This is not a product one would send their patient home with for overnight use.

Karen regularly sends us drawings for custom-made JoViPitPaks® and as we develop new products that we feel would be helpful for a wide range of patients, we will add them to our inventory.  It is clear this project will continue to evolve and we will do our best to keep you informed either by our blogs or  our website.

It’s been a busy week.  Carol Johnson, OTR/L from North Carolina has recently joined the JoViPak staff and we spent most of our time last week working on product development and writing letters to our legislators in Washington D.C. asking for their support of the House Bill 4662.  (Refer to my previous blogs.)  As therapists we want our lymphedema patients to have the best care possible and it is very difficult for us to watch our elderly clientele go without because Medicare won’t pay for their treatment or the products they need to manage their condition.

The author of this bill is Bob Weiss whose wife has struggled with lymphedema for years.  It continues to amaze me how much effort and personal expense he as invested into being an advocate for the lymphedema community.  Both he and Carol will be meeting with several legislators next month in Washington D.C. to discuss the various aspects of this bill.

As we get caught up in our enthusiasm over the possibility of Medicare paying for lymphedema treatment and supplies, we can’t ignore one serious ramification.  What if Medicare takes it on and gives lymphedema supplies, e.g. compression garments, HCPC billing codes and reimbursement amounts that are far below the cost to manufacture these products or the wholesale cost to resellers.  It is safe to assume that once Medicare establishes a price, other insurance companies will follow.  If in doing that, we force the manufacturers and the DME’s who sell these products out of business, then what?  Where does that leave the patient?  Will they have to look to other countries to provide them with cheaper and quite probably inferior quality products?

Please ask your legislators to support this bill, and it is important that you also ask them to consider, as well as support those people providing the goods and services by acknowledging their right to charge the patient for any shortfall not covered by the Medicare reimbursement.