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What is Lymphedema?
What is LE - What is Lymphedema?
Lymphedema (lymph = lymph fluid; edema =swelling) is an abnormal swelling of
the body part, most often an extremity, but it can occur in the face, neck
or abdomen. The swelling is the result of an accumulation of protein-rich
lymph fluid in the affected area. This occurs when the lymphatic system,
which transports waste material (proteins, inorganic substances, water,
fats, dead or damaged cells), is absent, underdeveloped or impaired in some
way. The World Health Organization estimates that over 170 million suffer
with Lymphedema.
Who is at risk?
Secondary Lymphedema: Cancer survivors who have had lymph nodes removed
and/or radiation therapy. Also, those who have had an injury, surgery,
trauma or parasite infection.
Primary or Congenital Lymphedema: People who are born with an underdeveloped
lymphatic system can develop it at birth, during puberty or after the age of
35.
For more detailed information on 'Understanding Lymphedema Pathophysiology and Treatment'
See the past issue archives: Issue 1 Vol: 1 or copy this link
http://www.elymphnotes.org/detail.asp?ci=8&it=IPI
Stages or Grades of Lymphedema
· Grade 1 - when the skin is pressed the pressure will leave a pit that takes some time to fill back in. This is referred to as pitting edema. Sometimes the swelling can be reduced by elevating the limb for a few hours. There is little or no fibrosis (hardening) at this state, so it is usually reversible.
· Grade 2 - when the swollen area is pressed, it does not pit, and the swelling is not reduced very much by elevation. If left untreated, the tissue in the limb gradually hardens and becomes fibrotic.
· Grade 3 - the lymphedema is often called elephantiasis. It occurs almost exclusively in the legs after progressive, long term, and untreated lymphedema. At this stage there may be gross changes to the skin and it may protrude and bulge. There may be some leakage of fluid through the tissue in the affected area, especially if there is a cut or sore. While lymphedema will respond to treatment at this state, it is rarely reversible.
What is Manual Lymphatic Drainage treatment?
Manual Lymph Drainage is a highly specialized massage technique performed by physical therapists certified in lymphedema treatment.
Although an excellent form of treatment, many patients find the continuous bandaging very difficult. Often the bandaging must be done every day for life once a patient finishes therapy. The treatment has limited coverage from Medicare and Insurance companies.
Manual Lymph Drainage uses a specific light-pressure stroking action to stimulate the lymph vessels just below the surface of the skin.
Manual Lymph Drainage then works to stimulate the lymph vessels on the "good unaffected side" of the body (trunk region) which then helps suction lymph fluid from the "bad affected side" of the body. The therapist guides the fluid from sluggish lymph areas to various healthy lymph regions that are effective in draining excessive fluid. After the trunk or abdomen is decongested/drained, the upper part of the arm or leg is treated and then is followed the distal part and the limb.
Manual Lymph Drainage helps the lymph system remove excess water, protein and other wastes from connective tissues in the arm. The lymph system then rids the body of this excessive fluid by eventually dumping it back into the blood stream.
Prevention Tips
Activity / Lifestyle
Gradually build up the duration and intensity of any activity or exercise.
Take frequent rest periods during activity to allow for limb recovery.
Monitor the extremity during and after activity for any change in size, shape, tissue, texture, soreness, heaviness or firmness.
Maintain optimal weight.
Skin Care - Avoid trauma/injury and reduce infection risk
Keep extremity clean and dry.
Apply moisturizer daily to prevent chapping/chaffing of skin.
Attention to nail care; do not cut cuticles.
Protect exposed skin with sunscreen and insect repellent.
Use care with razors to avoid nicks and skin irritation.
If possible, avoid punctures such as injections and blood draws.
Wear gloves while doing activities that may cause skin injury (i.e., gardening, working with tools, using chemicals such as detergent).
If scratches/punctures to skin occur, wash with soap and water, apply antibiotics, and observe for signs of infection (i.e. redness).
If a rash, itching, redness, pain, increased skin temperature, fever or flu-like symptoms occur, contact your physician immediately.
Avoid limb constriction
If possible, avoid having blood pressure taken on the at risk arm.
Wear loose fitting jewelry and clothing.
Compression Garments
Should be well-fitting.
Support the at risk limb with a compression garment for strenuous activity (i.e. weight lifting, prolonged standing, running).
Wear a well-fitting compression garment for air travel.
Extremes of Temperature
Avoid exposure to extreme cold, which can be associated with rebound swelling, or chapping of skin.
Avoid prolonged ( > 15 minutes) exposure to heat, particularly hot tubs and saunas.
Avoid immersing limb in water temperatures above 102° F.
Additional practices specific to lower extremity lymphedema
Avoid prolonged standing or sitting.
When possible, avoid crossing legs.
Wear proper, well-fitting footwear.
Prevention tip update source: NLN
This section is uncomplete and under construction. We invite you to come back for more as additional information will be posted shortly. In the mean time, you may review the current issue and the past issue archives for additional details on Lymphedema. Or feel free to join in on the online forum or online support group Q&A.
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