What is Lymphedema?

Lymphedema is chronic swelling in a portion of the body, usually an arm or a leg which occurs because of damage to the lymphatic system. The fluid is lymph which is protein rich & accumulates in the tissue spaces under the skin. A healthy lymphatic system would return this fluid to the circulatory system but due to the lymph node dissection, radiation and scarring, the lymph accumulates and causes swelling.

Types of Lymphedema

Primary Lymphedema – the lymphatic system does not develop normally; it is congenital. This can develop at birth (neonatum), at puberty (coxum) or after 35 (tarda). Some portion of lymph vessels and/or nodes will be missing.
Secondary Lymphedema – occurs due to damage as a result of surgical removal of lymph nodes due to cancer; also occurs as a result of radiation treatments, scarring, traumatic injury, cosmetic surgery, amputation, obstruction of a venous system.

Diagnosis of Lymphedema
See your doctor so that they can rule out any other possible causes of swelling. If the lymphedema is post cancer, you must be cancer free before lymphedema treatments can commence.

Cancer treatment is the leading cause of Lymphedema.

Darlene has successfully completed 160 hrs of certification offered by the Dr Vodder International School indicating the ability to apply Manual Lymph Drainage (MLD) Combined Decongestive Therapy (CDT) & compression bandaging. The Vodder technique is a highly advanced technique based on solid scientific research & includes all components of MLD/CDT.

Combined Decongestive Therapy Includes:
Manual lymph drainage – specialized massage techniques designed to help the lymph drain properly.

Compression bandaging – applied to the entire limb after every treatment in order to prevent refilling of the limb. Must be worn for 23 hrs per day in phase 1. In phase 2, a custom made compression garment will be fitted and worn.

Decongestive exercises – given to the patient to be done while wearing garment or bandaging. Exercises activate the muscle joint pump & lymph flow which helps reduce swelling.

Skin care – crucial as infections such as cellulitis or fungal infections can be a serious complication of lymphedema. Meticulous skin care is an essential part of CDT.

   Symptoms of Lymphedema

Lymphedema causes swelling with a feeling of heaviness & tightness. Usually only one limb is involved & it will be larger than the other. Look for the following signs:
A dull ache in the affected limb
A feeling of tightness in the skin of the limb
Difficulty moving or bending a limb
Pitting – indents left by your thumb in the swollen tissue
Indentations left when you take off your socks, rings or watches.
Swelling or redness around scars or radiation sites or sites of lymph node removal 

Stages of Lymphedema
Latency stage – No swelling, capacity of lymph system to transport lymph is reduced, skin is normal. After node removal you are in this stage.
Stage 1 – Reversible – edema is soft, will pit, will go away if limb is raised, no secondary tissue changes.
Stage II – Spontaneously irreversible – Fibrosis present including hardening & thickening of the skin which impairs healing & prevents proper drainage.
Stage III – Lymphostatic elephantiasis – Extreme increase in volume & texture with skin developing hardening, thickening & numerous deep folds.

                   There is no cure for Lymphedema, there is only management.