What is Lymphedema?

Lymphedema is a condition characterized by swelling in one or more extremities that results from impaired flow of the lymphatic system.

The lymphatic system is a network of specialized vessels (lymph vessels) throughout the body whose purpose is to collect excess lymph fluid with proteins, lipids, and waste products from the tissues. This fluid is then carried to the lymph nodes, which filter waste products and contain infection-fighting cells called lymphocytes. The excess fluid in the lymph vessels is eventually returned to the bloodstream. When the lymph vessels are blocked or unable to carry lymph fluid away from the tissues, localized swelling (lymphedema) is the result.

• Primary lymphedema is the result of a design flaw of the lymph vessels and is a rare, inherited condition. (Congenital, Praecox or Tarda)
• Secondary lymphedema results from an identifiable damage to or obstruction of normally functioning lymph vessels and nodes (ie. Operations, Radiation Therapy, Infections, Trauma or Obesity). Worldwide, lymphedema is most commonly caused by filariasis (a parasitic infection), but in the U.S., lymphedema most commonly occurs in women who have had breast cancer surgery, particularly when followed by radiation treatment.

Signs & Symptoms

First signs and symptoms of lymphedema may include the sensation of tightness or fullness, heviness, discomfort/achiness, but not pain. The long-term accumulation of fluid and proteins in the tissues leads to inflammation and eventual scarring of tissues, leading to a firm, taut swelling that does not retain its displacement when indented with a fingertip (non-pitting edema).

With longstanding cases of lymphedema, the skin in the affected area thickens and may take on a lumpy appearance described as an orange-peel (peau d'orange) effect. The overlying skin can also become scaly and cracked, and secondary bacterial or fungal infections of the skin may develop. Affected areas may feel tender and sore, and may have a loss of mobility/flexibility.

The immune system function is also suppressed in the scarred and swollen areas affected by lymphedema, leading to frequent infections, and even a malignant tumor of lymph vessels known as lymphangiosarcoma.

Our Treatment Approach

Lymphedema cannot be cured, but it can be effectively treated. The treatment program we provide is known as Complete Decongestive Therapy (CDT). Its goals are to utilize other lymphatic pathways, decongest edematous body parts, eliminate fibrotic (scar) tissue in the later stages of lymphedema, avoid reaccumulation of lymph fluid, prevent or eliminate infections, maintain normal or near normal limb size, and teach our patients how to independently manage their lymphedema.

CDT consists of five components:

• Manual Lymph Drainage (MLD): A gentle manual technique of special massage strokes which re-routes the lymph flow around the blocked areas to the healthy lymphatic system.

• Compression bandaging: Short stretch bandages are applied to increase tissue pressure in the affected extremity and prevent the return of evacuated fluid after MLD.

• Remedial exercise: Increases venous and lymphatic return.

• Meticulous skin and nail care: Eliminates bacterial and fungal growth, reduces the chance of infection.

• Instruction in self-care: Ways to continue your treatment at home.

Patient Guidelines

Progression of lymphedema after onset can be controlled by keeping the involved area clean and moisturized, not allowing any kind of needle-stick (blood draws or injections) or have your blood pressure taken on the at-risk or involved extremity. Medical alert bracelets or necklaces are available to notify care-givers.

        • Use an electric razor when shaving the involved area.

        • Wear loose clothing.

        • Eat a well-balanced diet.

        • Avoid injury to the extremity (cuts, bruises, scratches, etc.)

Bandaging Supply Options

Local suppliers/custom fitters: Everything Medical
                                            (585) 271-2080
                                            919 Westfall Rd, Bldg B-200
                                            Rochester, NY 14618
                                            www.everything-medical.com

Online supplier:                      Lymphedema Products, LLC 
                                            (866) 445-9674
                                            www.lymphedemaproducts.com

More Information

The National Lymphedema Network (NLN) (http://www.lymphnet.org/) is a non-profit organization founded in 1988 to provide education and guidance to lymphedema patients, health care professionals, and the general public by disseminating information on the prevention and management of primary and secondary lymphedema.