Lymphedema is swelling caused by fluid retention in the arms and legs. The causes are many, from hereditary defects to surgical removal of lymph nodes. Although lymphedema is most commonly thought of as a woman's disease, men also can develop this disease. Lymphedema can be disfiguring, painful and disabling. But, it doesn't have to be. There is help for those suffering from the effects of lymphedema. The earlier treatment is started, the better the prognosis for recovery.
Glendale Memorial offers a comprehensive lymphedema management program utilizing the latest treatment techniques. The following information will help you to understand how lymphedema develops, as well as prevention and treatment information.
What is Lymphedema? The lymphatic system is a part of the circulatory system, which consists of a network of lymphatic vessels, pathways, and nodes. These vessels carry the high protein lymph fluid from the spaces between the body's cells to the lymph nodes. From there it is filtered and purified of bacteria, toxins and dead cells. The cleansed fluid is then returned to the circulatory system.
Lymphedema is a swelling, usually of the arms or legs that results from poor or abnormal lymph flow through the lymphatic vessels. Although it is a chronic and progressive disease, lymphedema can usually be brought under control through medical care, and some lifestyle changes.
Primary lymphedema occurs without any obvious cause. It is more common in women and usually appears in the legs. It occurs when an intrinsic fault develops within the lymph conducting pathways. There is often a hereditary connection with this type of lymphedema.
Secondary lymphedema is caused by injury, scarring, surgical removal of lymph nodes, or radiation in combination with surgery. Many people can develop lymphedema as a result of treatment for breast, uterine, bladder, ovarian, prostate, testicular cancer, hernia surgery, malignant melanomas and lymphomas. Today, it is estimated that there are 2.5 million cases of secondary lymphedema in the United States -- the majority caused by breast cancer surgery.
Lymphedema may not appear immediately after surgery or radiation; it may occur weeks, months or even years later. And the triggers are just as imprecise; a simple scratch or cut, a trauma or even an airplane flight can set off an episode of lymphedema.
What are the symptoms of lymphedema?
The sypmtoms of lymphedema include:
- Swelling of a limb or body part (usually begins in the hands or feet);
- Condition worsens over time;
- Heaviness and limitation of movement;
- Repeated infections (cellulitis); and
- Thickening skin; or Difficulty fitting into clothing.
Early diagnosis and treatment improves both the prognosis and the condition. If you notice a rash, blistering, redness or fever, see your physician immediately. This could trigger the onset or a worsening of lymphedema. Do not ignore even the slightest swelling. Please seek medical attention immediately.
How does lymphedema encourage infection?
Lymph fluid is rich in protein. When the lymphatic system's flow is blocked, fluid accumulates and stagnates in the limb. This creates a very favorable environment for bacteria to thrive. If you have lymphedema, it is important that you see a physician so that any cuts or signs of infection can be treated immediately.
How do I reduce the chances of developing lymphedema?
If you have had your lymph nodes removed and/or are receiving radiation therapy, you are at significant risk of developing lymphedema. Additionally, axillary resection increases the risk of development of lymphedema because the lymph channels are destroyed.
To reduce the chances of developing lymphedema:
- Avoid temperature extremes -- hot baths, hot tubs, saunas or sunbathing;
- Avoid infections -- insect bites, pet scratches, cutting cuticles during a manicure or pedicure, shots, blood draws or acupuncture in the at-risk limb;
- Avoid blunt trauma -- lifting objects more than 15 pounds, repetitive motions using resistance (this includes golf, weight training and tennis, as well as scrubbing floors and windows);
- Avoid constricting clothing or jewelry that interferes with circulation; and
- Avoid having blood pressure taken in at-risk limbs.
What precautions should I take?
- Eat nutritiously (a low-fat, low-salt diet, lots of fresh fruits and vegetables);
- Avoid alcohol and nicotine; decrease coffee intake;
- Avoid being overweight; Keep skin and hair clean; use an electric razor;
- Use hypoallergenic soaps and fragrances;
- Sleep with limb elevated;
- Travel with limb elevated;
- Wear compression sleeves/bandage when flying or at high elevations;
- Wear gloves for housework or gardening; and
- Avoid the use of diuretics -- they remove the fluid but not the protein in the channels. Your lymphedema will worsen as your body tries to increase fluid to the area to remove the protein.
What type of treatment is available?
The treatment of choice for lymphedema is called Comprehensive/Complex/Complete Decongestive Physical Therapy (CDPT). At Glendale Memorial Hospital and Health Center, we offer a comprehensive Lymphedema Management Program.
Our specially trained and certified physical therapists begin with a thorough assessment, including the patient's chief complaints, medical history, medications, range of motion, strength, skin integrity, limb girth measurements and functional limitations. Based on this assessment and the doctor's recommendations, the therapist will develop an individualized treatment plan.
Treatment of lymphedema may include:
- Education regarding skin care, risk factors and prevention strategies;
- Manual lymph drainage performed with a very light touch to avoid injury to delicate lymphatic vessels. This encourages the reabsorption and flow of the fluid back toward the heart by re-routing the lymph flow around blocked areas into healthy lymph vessels;
- Lymphedema exercises that mimic the motions and sequence of the manual lymph drainage by activating the muscle and joint pumps to move the fluid out of the limb.
How can I find out more about lymphedema?
For more information about lymphedema and treatment options, contact: The Lymphedema Management Program at Glendale Memorial Hospital and Health Center at (818) 502-2299.
