Frequently Asked Questions
Lymphatic Care And Wellness – Dr. Shanie Dasrath MOT, OTD, OTR/L, LMT, CKTP, MLD-C, CLT-LANA, CPST, ALM, CYT-200, PF1
ABOUT THE PRACTICE
Q: Who do you work with?
I support adults, young adults or children who are:
Recovering from surgery (cosmetic, oncologic, orthopedic, etc.)
Living with lymphedema or lipedema
Experiencing swelling, heaviness, or tissue changes
Dealing with chronic pain, tension, or stress
Wanting to support their lymphatic system and overall wellness
I offer in-studio sessions in Ankeny, IA, mobile/home visits within a set radius, and online coaching for clients who live farther away.
Q: Who will I see for my session?
You’ll always see me, Dr. Shanie Dasrath. I am a doctorally trained occupational therapist (OTD), licensed massage therapist (LMT), and certified lymphedema therapist (CLT-LANA) with specialized training in lymphatic, post-operative, lymphedema, and lipedema care.
SERVICES & WHAT TO BOOK
Q: What’s the difference between Therapeutic / Medical Massage and Lymphatic Wellness (MLD)?
Therapeutic / Medical Massage focuses on muscles, joints, fascia, and nervous system. It’s best for pain, tension, stress, and general body discomfort.
Lymphatic Wellness – MLD uses very light, rhythmic techniques to support lymph flow and mild swelling, and to promote recovery and relaxation. It’s best for puffiness, feeling “inflamed,” or wanting gentle lymph support.
Q: When should I book Post-Op / Lymphedema / Lipedema Intensive instead of Lymphatic Wellness?
Choose Post-Op / Lymphedema / Lipedema if:
You’ve had recent surgery and have significant swelling or discomfort
You’ve been diagnosed with lymphedema or lipedema
You have chronic, ongoing swelling, heaviness, or fibrosis
You need help with compression garments, bandaging, or long-term management
Choose Lymphatic Wellness – MLD if your swelling is mild or you are primarily looking for lymph support and wellness.
Q: Do you offer home visits or mobile care?
Yes. I offer mobile / home visits for lymphedema, lipedema and post-op services within a defined radius from my Ankeny location. A separate travel fee is added based on distance to cover travel time, mileage, and set-up.
Q: Do you offer online coaching?
Yes. I provide online coaching for lipedema and lymphedema via secure video. These sessions focus on education, self-management strategies, garment guidance, movement ideas, symptom tracking, and support. Coaching is not a medical visit or diagnosis and does not replace hands-on care or your medical team.
Pelvic Floor Therapy – FAQ
Q: What is pelvic floor therapy?
Pelvic floor therapy is specialized, one-on-one care that focuses on the muscles, fascia, nerves and connective tissues of the pelvis, hips, core and lower back. I use assessment, manual therapy, neuromuscular re-education, breath work, and individualized exercises to help with bladder and bowel symptoms, pain, prolapse, postpartum recovery and overall pelvic health.
Q: Who is pelvic floor therapy for?
I work with both male and female adults, teens, young adults who are experiencing:
Urinary urgency, frequency, leaking or incomplete emptying
Constipation, straining or bowel changes
Pelvic, hip, tailbone, low back or abdominal pain
Prolapse symptoms (heaviness, bulging, pressure)
Pregnancy and postpartum concerns
Pain with intercourse or pelvic exams
Changes after surgery, trauma, or chronic pain conditions
If you’re unsure whether pelvic floor therapy is right for you, you can contact me with a brief description of your symptoms and I’ll let you know if it’s a good fit.
Q: What happens during the first pelvic floor visit?
Your 90-minute initial evaluation includes:
A detailed history and conversation about your symptoms, goals, daily life and medical background.
Posture, breathing, hip, spine and abdominal assessment.
Pelvic floor assessment (external and/or internal), only if appropriate and with your consent.
Initial treatment and strategies (manual work, breath, positioning, early exercises).
A personalized plan, including home exercises and next-step recommendations.
Nothing is done without your permission, and you can pause or stop any part of the session at any time.
Q: Will I have an internal pelvic floor exam? Do I have to?
An internal exam (via the vagina and/or rectum) is one possible tool, but it is never required.
We will talk through what an internal exam involves and decide together if it’s appropriate and aligned with your comfort, history and goals.
If you prefer not to have an internal exam, we can still do very effective work using external assessment, breath, movement, and nervous system regulation.
You are always in control of what happens with your body during sessions.
Q: What should I wear to my pelvic floor appointments?
Wear or bring soft, loose, comfortable clothing. Many people choose:
Yoga pants/shorts or joggers
A loose top or sports bra
Layers if you tend to get cold
We may need to see how you breathe and move through your ribs, abdomen, hips and pelvis. You’ll always be draped and positioned for comfort and privacy.
Q: How many pelvic floor sessions will I need?
It depends on your symptoms, history and goals, but common ranges are:
Milder urinary issues or early postpartum: about 4–8 visits over 2–3 months
More complex pain, prolapse, long-standing constipation, birth injuries: often 8–12+ visits, typically over 3–6 months
Chronic or multi-factor cases: longer-term rehab with phases (more frequent at first, then tapering to monthly or occasional tune-ups)
Most people start with a 90-minute evaluation and then 60-minute follow-ups weekly or every other week at first. We reassess regularly and adjust as you improve.
Q: Can I come for pelvic floor therapy if I’m pregnant?
In many cases, yes. Pelvic floor therapy can be very helpful during pregnancy for managing pain, preparing for birth, supporting bowel/bladder function and learning strategies for postpartum recovery.
If your pregnancy is high-risk or you have specific medical concerns, I may request clearance or guidance from your OB/midwife before certain techniques.
Q: Is pelvic floor therapy painful?
Pelvic floor therapy should not feel like you are being pushed past your limits. Some techniques may feel new, intense or emotional, but we continually track your comfort and nervous system response.
You can always say “no,” “stop,” or “not today” to any technique.
We can focus more on gentle work, breath, and nervous system support if you are sensitive, in a pain flare, or have a trauma history.
My goal is to build safety, trust, and long-term change—not to push you through pain.
Q: I have a history of trauma. Is pelvic floor therapy still appropriate?
Many people seeking pelvic floor care have a history of medical, birth, or personal trauma. I approach all pelvic work with a trauma-informed lens:
You are in charge of what we do and don’t do.
We move at your pace, and consent is ongoing—not a one-time checkbox.
We can focus on external work, education and self-regulation first, and only consider internal work if/when you feel ready (or not at all).
If you’d like, you can let me know your concerns ahead of time via message so we can plan a safer-feeling first visit.
Q: Do I need a referral from my doctor for pelvic floor therapy?
A formal referral is not required for most clients, but I’m happy to collaborate with your medical team. If you’ve had recent surgery, a high-risk pregnancy, or complex medical conditions, I may ask for confirmation that pelvic floor therapy is appropriate at this time.
Q: Do you bill insurance for pelvic floor therapy?
I am an out-of-network, self-pay provider and do not bill insurance directly. Many clients use HSA/FSA cards for pelvic floor therapy. If your plan allows, I can provide a receipt or summary you may submit for potential reimbursement.
BOOKING & SCHEDULING
Q: How do I book an appointment?
I use Square Appointments for scheduling and payment.
You can request to book online 24/7 using my contact form on my website - lcw.rehab/contact
Or you can contact me directly by text or call at 515-257-6572.
Text is usually the fastest way to reach me—please include your name, a brief description of what you’re dealing with, and your preferred days/times. I’ll reply to help you choose the right service and get your appointment scheduled.
I do require a credit card to be held on file to book and hold all appointments.
Q: I’m not sure which service to choose. What should I do?
You’re not alone—that’s very common. You can:
Read the Description of Therapy Services guide on my site (lcw.rehab/services), or
Send me a message or text with: your main symptoms, any diagnoses or surgeries, and your goals.
I’ll help you choose the best service and length for your needs.
Q: How far in advance should I book?
Appointments can fill quickly, especially for post-op care. Whenever possible, I recommend:
Post-op clients: pre-booking a series of sessions before surgery or as soon as you receive your surgical date.
Lymphedema/lipedema: scheduling a longer initial visit, then follow-ups every 1–2 weeks at first.
Pelvic floor clients: scheduling a longer initial visit, then follow-ups as described above.
I do my best to offer flexible options, including some later or weekend hours when available.
CANCELLATIONS, LATE ARRIVALS & NO-SHOWS
Q: What is your cancellation policy?
Because I reserve this time specifically for you, I request at least 24 hours’ notice to cancel or reschedule.
Cancellations with less than 24 hours’ notice, or no-shows, may be charged a late cancellation fee up to the full session amount.
Late cancellations (less than 24 hours’ notice): charged 50% of the scheduled session fee.
No-shows or same-day cancellations (less than 4 hours’ notice): charged 100% of the scheduled session fee.
For mobile/home visits, the travel fee may also be charged if I have already begun travel or am within the same-day window.
I understand that emergencies happen. If there is a true emergency, please contact me as soon as possible and we’ll discuss options.
For mobile/home visits, longer notice may be required due to travel.
Details are provided in your booking confirmation and reminder messages and on the website.
Q: What happens if I’m late?
I’ll do my best to provide as much care as possible within your remaining time. Out of respect for clients scheduled after you, sessions typically cannot be extended if you arrive late, and the full session fee will still apply.
PRICING, PAYMENT & TIPPING
Q: How much do sessions cost?
Pricing varies by service type (therapeutic, lymphatic wellness, post-op/lymphedema/lipedema, mobile visits, and online coaching) and by length of session. You can view current rates on the Pricing page.
Q: How do I pay?
Payment is due at the time of service. I accept:
Major credit/debit cards.
HSA/FSA cards (where allowed by your plan).
Prepaid packages (when applicable).
All services - mobile or in office - require a card to be held on file to book and hold appointments.
Q: Do you accept tips?
My session fees are set to reflect the time, training, and care involved in each visit, so tips are never expected or required.
If you choose to leave a tip, it is always appreciated but completely optional. The greatest compliment is your continued care and referrals.
MEMBERSHIP/SUBSCRIPTION & PACKAGES
Q: What’s the difference between a membership/subscription and a package?
A membership or subscription is an ongoing, month-to-month plan. You’re billed regularly (for example, 1–2 sessions per month) and you use those sessions during that month or within a short window. It’s perfect if you like a steady routine and want to maintain results with consistent care.
A package is a set number of visits you prepay for upfront (for example, 4 or 8 sessions). Packages usually offer a discount per visit and can be used over a longer period of time (3-6 months). They’re ideal if you know you’ll need a series of treatments, such as post-op recovery or ongoing lymphedema/lipedema care.
Q: Which is better for me—membership or packages?
Choose a membership/subscription if you:
Want regular, ongoing support (for example, monthly therapeutic or lymphatic wellness sessions).
Like having a standing self-care routine on your calendar.
Prefer smaller, predictable payments over time.
Choose a package if you:
Are recovering from surgery and need multiple sessions close together.
Have lymphedema or lipedema and are committing to an intensive phase of care.
Prefer to pay upfront, use the visits as you go, and receive a discounted rate per session.
If you’re not sure which option fits your situation, you can text or message me with a brief description of your goals, and I’ll help you choose the best fit.
INSURANCE, HSA/FSA & DOCUMENTATION
Q: Do you take insurance?
I am an out-of-network, self-pay provider and do not bill insurance directly. This allows us to focus on your needs without restrictions from insurance plans.
Q: Can I use my HSA or FSA card?
In many cases, yes—especially for medically-oriented services such as lymphatic, lymphedema, lipedema, and post-operative care. Coverage depends on your specific plan.
If needed, I can provide receipts or visit summaries you may submit to your plan for possible reimbursement.
Q: Do I need a referral from my doctor?
A formal referral is not required for most services, but I’m always happy to coordinate with your medical team. For complex medical conditions, recent surgery, or active infections, I may ask for confirmation that hands-on care is appropriate.
NEW CLIENTS & WHAT TO EXPECT
Q: What should I wear to my appointment?
For most sessions: soft, loose, comfortable clothing that is easy to move and adjust.
For lymphatic or full-body work: loose shorts, a soft top or sports bra often work well.
For post-op clients: avoid tight waistbands or restrictive shapewear directly over surgical areas unless your surgeon has instructed otherwise.
You will always be draped appropriately to protect your comfort and privacy.
Q: What should I bring to my first visit?
Bring anything you feel is relevant, such as:
A list of your medications and diagnoses
Post-op instructions from your surgeon (if applicable)
Any compression garments, sleeves, stockings, or bandages you’re currently using
Previous therapy notes or measurements (optional but helpful)
Q: What happens during the first session?
Your first visit typically includes:
Conversation & history – we discuss your concerns, goals, and relevant medical history.
Assessment – visual and hands-on assessment as appropriate (swelling, tissue changes, movement, comfort level).
Treatment – therapeutic massage, MLD, or specialized lymphatic/post-op work depending on your needs and booking type.
Education & plan – we review what I found, what you can expect, and recommendations for follow-up, self-care, movement, and/or garments.
POST-OP SPECIFICS
Q: How soon after surgery can I start lymphatic/post-op care?
This depends on your surgeon’s protocol and your healing. Some clients are cleared within a few days, while others may need to wait longer. I always follow your surgeon’s instructions and work within what is safe and comfortable.
When in doubt, ask your surgeon:
“When am I cleared for gentle lymphatic massage or MLD with a trained therapist?”
However, MLD can be started right after surgery - hours or next day - as it will help decrease pain and swelling, improving your recovery journey.
Q: Will you work on my incisions, drains, or sutures?
I will always work within my scope of practice, avoid areas that are healing, or areas that are not cleared by your surgeon. All techniques are adapted based on your stage of healing, comfort, and medical guidance. I utilize laser therapy for healing wounds, healing incisions, and other areas.
LYMPHEDEMA & LIPEDEMA
Q: Can you diagnose lymphedema or lipedema?
No. Diagnosis must be made by a qualified medical provider. As LANA certified CLT Occupational Therapist I can:
Help you understand your diagnosis
Educate you on self-management strategies
Assist with compression education, garment use, movement, and lifestyle adjustments
Collaborate with your medical team when appropriate
Q: Do you provide complete decongestive therapy (CDT)?
Yes. I provide lymphatic-focused care using CDT principles, including MLD, bandaging, education, exercise, skin care, and garment guidance.
MOBILE / HOME VISITS
Q: How do mobile/home visit sessions work?
I will see you in the comfort of your home for lipedema, lymphedema, or post-op care.
You’ll need:
A clean, clear space for me to work in and move around
A comfortable area to sit or stand as needed
A comfortable couch, recliner or chair to sit/ recline in comfortably
Access to a restroom and a safe, comfortable environment
Mobile sessions are billed at mobile rates plus a travel fee based on distance from my location.
Q: How is the travel fee calculated?
The travel fee is based on one-way distance from my office to your location, within a set mileage range (up to a maximum distance). This fee covers:
Drive time
Mileage/vehicle costs
Load-in, set-up, and breakdown
The exact fee will be confirmed when you book based on your address.
ONLINE COACHING
Q: What’s the difference between online coaching and an in-person session?
Online coaching is education, strategy, and support via video. I help you understand your condition, review your routines, discuss garment options, and build a realistic self-care plan.
In-person sessions involve hands-on techniques (like MLD and therapeutic massage) in addition to education.
Coaching is ideal if you live outside my local area or are primarily looking for guidance and a plan.
Q: Can you coach me if I live in another state or country?
Yes, as long as we are clear that online coaching is educational and supportive only. It does not replace medical care, diagnosis, or in-person treatment, and I will always encourage you to maintain regular follow-up with your local providers.
SAFETY & MEDICAL CONSIDERATIONS
Q: Are there times when I should NOT receive lymphatic or massage work?
Yes. In some situations, hands-on work may be delayed or modified, such as:
Active infection (cellulitis, fever, feeling acutely ill)
Blood clots or suspected DVT
Uncontrolled heart failure or serious cardiac conditions
Uncontrolled kidney failure
Uncontrolled or unstable medical conditions
If you are unsure, please ask your medical provider first or contact me with questions. Your safety is always the priority.
Q: Can you work during pregnancy?
In many cases, yes—with modified techniques and positions. Please let me know if you are pregnant or trying to conceive so I can adapt your session appropriately. For high-risk pregnancies, I may request clearance from your provider.
CONTACT
Q: How can I contact you if I have questions?
You can reach me by:
Text or call: 515-257-6572
Email: lcwrehab@gmail.com
Online booking & contact form: lcw.rehab/contact
If you’re not sure where to start, send a brief message about what you’re dealing with, and I’ll guide you toward the best next step.