Lymphedema: What Is It?...And What Can Be Done About It?By: Derek Spinney, PT, CSCS Director of Rehabilitation Service Eisenhower Medical Center
LYMPHEDEMA IS THE CHRONIC SWELLING OR FEELING OF TIGHTNESS IN THE ARM, HAND OR LEG DUE TO AN ACCUMULATION OF LYMPHATIC FLUID IN THE SOFT TISSUE OF THE ARM.
To better understand what lymphedema is, let’s first discuss the lymph system. All of us have two circulatory systems – the blood vessels that carry blood, and the lymphatic system, which carries a clear-colored fluid called lymph. Lymph removes bacteria and certain proteins from tissue, transports fat from the small intestine, and supplies white blood cells into our blood. While little has been known about this system until the last 25 years, the lymphatic system moves fluid around the body through contractions of muscles. The lymphatic fluid cleans infection from our bodies. The lymphatic system represents the “refuse workers” of the body and is often undervalued; yet, we all know often from experience how important the refuse drivers are for the health and cleanliness of a city, which is in essence what the lymphatic system does for our bodies.
Causes of Lymphedema
When this system becomes interrupted as a result of axillary (underarm) lymph node removal, which is commonly performed on breast cancer patients, lymphedema may occur. When the body produces more fluid than the lymphatic system can transport, the protein-rich fluid collects in the tissues of the affected areas and creates swelling. Left untreated, this fluid not only causes the transport system to enlarge, but also reduces oxygen availability in the transport system, interferes with wound healing, and provides a culture medium for infection. Approximately 400,000 breast cancer survivors must cope with this condition on a daily basis.
Symptoms of Lymphedema
Lymphedema can develop in any part of the body or limb(s). It can develop after surgery or radiation for any type of cancer, but most often with breast cancer, lymphoma, melanoma or pelvic cancer. Signs or symptoms of lymphedema to watch out for include: a “full” sensation in the limb(s), skin feeling tight, decreased flexibility in the hand, wrist, elbow, ankle, difficulty fitting into clothing in one specific area, or ring/wristwatch/bracelet tightness. If you notice persistent swelling, it is important to seek immediate medical advice as early diagnosis and treatment improves both the outcome and the condition.
Eisenhower offers a lymphedema management program through the Rehabilitation Services Department. We have four occupational and physical therapists that have been nationally certified in Complete Decongestive Therapy. This specialized service is covered by most insurance with a prescription from your physician. For further information on this program, please call Eisenhower’s Rehabilitation Department at 760-773-1630.
Treatments for Lymphedema The recommended treatment plan is first prevention. Avoid any injuries to a body part which has been affected by surgery or radiation. Whenever possible, do not have blood pressure or injections to that arm. Immediately attend to any injuries to avoid infection or swelling. Avoid any constrictive clothing or jewelry. Try to avoid becoming overweight. Monitor exercise and activities to not overwork the body part. If taking long flights or if you are a frequent flyer, wear a compression sleeve or stocking. If lymphedema should occur, treatment utilizing Complete Decongestive Therapy methods can help, and include: Manual lymphatic massage – a specialized massage which assists the lymph system in moving lymphatic fluids Bandaging and compression garments which provide compression and prevents further accumulation of fluids Proper skin care and diet – to prevent infections Exercises – to help move the fluids