LYMPHEDEMA

Lymph Vessel System

As well as blood circulating in our bodies, we also have a second circulating system, the lymph vessel system. This system’s role is to remove excess fluid, bacteria, viruses and waste products from body tissues and the space around the cells. Most of the tissue fluids return to the heart via the veins. The rest (about 2 litres/day) is transported back to the blood stream via lymphatic vessels.

When the lymph vessel system is damaged or stressed, it is unable to return all this fluid to the blood stream and the symptoms of lymphedema appear. When left untreated, there is an increased risk of infection, skin changes and discomfort.

Lymphedema

Lymphedema is swelling of a body part, most often an arm or a leg, caused by the abnormal accumulation of lymph fluid. It can also occur in the face, neck, chest, breast, abdomen, groin and lung.

In North America, lymphoedema is still not a widely known condition. The diagnosis is often missed by medical personnel. If it is diagnosed, many people are told that there is no treatment and that they must learn to live with the symptoms. Traditional treatments usually offer temporary solutions which may in the long term make the symptoms worse.

However, once treated with Combined Decongestive Therapy, lymphedema can be brought under control. Although it is a chronic and progressive condition, lymphoedema can be compatible with a normal and active lifestyle.

Symptoms

This condition most often causes a feeling of heaviness, swelling of a limb or body part, discomfort and pain, repeated episodes of infection and thickening of the skin. As the condition progresses, affected limbs can become hardened, there can be leakage of lymph and the size of the limb can continue to grow.

This can lead to problems such as difficulty finding clothing or shoes, multiple hospitalizations, altered lifestyles and constant medical care and expenses.

Primary or Secondary?

Lymphedema is either primary or secondary. Primary cases are those that occur without any obvious cause. They may be present at birth or occur later in life. Some cases have a family history of the condition.

Secondary lymphoedema is caused by an injury, scarring or removal of the lymph nodes. In North America, this usually occurs as a result of previous radiation and/or surgery of the lymph nodes in the neck, armpit, pelvis or groin. Such treatments are commonly given for cancers of the breast, uterus, bladder, ovary, prostate or testicles and for malignant melanomas, sarcomas and lymphomas. Occasionally, secondary lymphoedemas are caused by trauma to or chronic infections of the lymph vessel system.

Signs of the Onset of Lymphedema

  • Initially symptoms may come and go
  • An increase in the size of the limb
  • A feeling of heat in the limb
  • A bursting sensation of the limb
  • Red patches may indicate an infection -- should see a doctor immediately
  • Puffiness
  • Pitting of the skin if pressed
  • Aching limb or aching of the back of the shoulder
  • Any swelling or heat in the chest on the same side as the operation
  • After abdominal surgery, a feeling of tenderness in the groin or bloating in the abdomen
  • Swelling in the thigh after removal or radiation to inguinal or pelvic lymph nodes

Treatment for Lymphedema

Lymphedema is a serious condition which indicates that the lymph vessel system is unable to handle the lymph load. As it is a progressive condition, treatment should ideally begin as soon as the problem is diagnosed or even better as a preventative program after radiation or removal of lymph nodes to prevent swelling from occurring.

The most effective form of treatment used by therapists in North America and Europe is Combined Decongestive Therapy. This includes:

Manual Lymph Drainage is a specialized type of massage which stimulates and improves the functioning of the lymph vessel system. In addition to this, lymph can be re-routed into existing pathways to improve lymphatic return to the blood stream.

  • Compression therapy includes compression garments and/or specialized bandaging of the affected limb.
  • Education includes basic information about the lymph vessel system, causes of lymphedema, self-massage and techniques for self-care and instruction in the use of compression bandages and garments.
  • Exercise recommendations and guidelines are given to fit the physical abilities and interests of the client.
  • Skin Care includes techniques and suggested products to keep the skin healthy, to improve its condition or to deal with problems.
  • Combined Decongestive Therapy offers a practical and long lasting solution for people who have lymphoedema or are at risk of developing this condition.


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