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What is lymphedema?
What causes lymphedema?
Are there different kinds of lymphedema?
Who is at risk for lymphedema?
What are some signs and symptoms of lymphedema?
Can lymphedema be prevented?
What can be done to decrease the risk of developing lymphedema?
What can be done to manage lymphedema?
Are there successful treatments for lymphedema?
What makes the treatment most effective?
Will the therapy work?
Will therapy cure lymphedema?
How do I begin treatment at the Lymphedema Treatment Center at Mercy?
Will my insurance cover treatment?
How will lymphedema affect my lifestyle?
Will other medical conditions affect lymphedema treatment?
What about air travel and exercise with lymphedema?
What is lymphedema?
Lymphedema is a swelling of a part of the body, caused by the accumulation of lymph fluid. Lymph fluid is a protein rich fluid produced by the body to fight infection. Swelling is typically seen in the extremities, but can occur anywhere in the body including the face, neck, abdomen, genitalia and trunk.
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What causes lymphedema?
Lymph fluid is filtered through the lymph nodes as it circulates through narrow vessels (similar to veins, arteries and capillaries) removing bacteria, toxins and dead cells. When the lymph nodes become infected, or have been damaged or removed, they lose their ability to transfer lymph fluid causing it to accumulate in the tissues. Lymphedema is sometimes present at birth or may develop naturally during adolescence or midlife due to a failure of the lymph system. Lymphedema can also develop as a result of trauma, localized swelling, infection, scarring or chronic venous insufficiency. Different types of surgeries can trigger lymphedema as can cancer treatments, such as the removal of lymph nodes and radiation therapy
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Are there different kinds of lymphedema?
Yes. Lymphedema is classified as either Primary or Secondary Lymphedema.
Primary lymphedema is a rare, inherited condition caused by problems with the development of lymph vessels in your body. Primary lymphedema occurs most frequently in women and usually affects the legs, rather than the arms.
Secondary lymphedema refers to any condition or procedure that damages the lymph nodes or lymph vessels can cause lymphedema. Causes may include:
Surgery can cause lymphedema to develop if the lymph nodes and lymph vessels are removed or severed. For instance, surgery for breast cancer may include the removal of one or more lymph nodes in the armpit to look for evidence that cancer has spread. If the remaining lymph nodes and lymph vessels can't compensate for those that have been removed, lymphedema may result in the arm.
Radiation treatment for cancer can cause scarring and inflammation of the lymph nodes or lymph vessels, restricting flow of the lymph.
Cancer cells can cause lymphedema if they block lymphatic vessels. For instance, a tumor growing near a lymph node or lymph vessel could become large enough to obstruct the flow of the lymph fluid.
Infection can infiltrate the lymph vessels and lymph nodes, restricting the flow of lymph fluid and causing lymphedema.
Parasites can also block lymph vessels. Infection-related lymphedema is most common in tropical and subtropical regions of the globe and is more likely to occur in undeveloped countries.
Injury that damages the lymph nodes or lymph vessels can also cause lymphedema.
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Who is at risk for lymphedema?
Individuals with a family history may be at increased risk for primary lymphedema. In the US, lymphedema is most commonly seen relating to cancer treatments involving the removal of lymph nodes, chemotherapy, and/or radiation therapy. However, lymphedema can also result from trauma, infection, or chronic venous insufficiency.
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What are some signs and symptoms of lymphedema?
- General symptoms may include, but are not limited to:
- Swelling of a limb or body part that usually begins in an arm, leg or foot
- Feeling of heaviness, fullness, achiness and/or limited movement in the affected area
- Repeated infections in the affected area
- Skin thickening, possibly with a clear fluid leaking from the skin
- Difficulty fitting an arm or leg into clothing
- Sudden or slow onset swelling that worsens over time
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Can lymphedema be prevented?
Unfortunately, there are no specific steps that can be taken to definitively prevent the onset of lymphedema. Healthy lifestyle habits are beneficial in many respects, but even with meticulous habits and risk reducing behaviors, a person at risk for developing lymphedema may still develop symptoms at some point.
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What can be done to decrease the risk of developing lymphedema?
Please click here for the National Lymphedema Network Position Paper on Risk Reduction.
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What can be done to manage lymphedema?
Seeking treatment early is an important part of manage lymphedema. As important is the individual’s commitment to their own well-being, self care and long term management with respect to treatment protocols.
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Are there successful treatments for lymphedema?
Yes. The standard of care for lymphedema treatment is referred to as Complete Decongestive Therapy (CDT). CDT is a treatment protocol designed to combat symptoms with a daily regimen of manual therapy, compression therapy, nutrition, skin care, exercise, and ongoing education. The treatment protocol requires a commitment from both the patient and the therapist typically requiring 10-20 treatment sessions depending on the severity of symptoms. Follow-Up visits are scheduled as appropriate. Components of CDT include:
Manual Lymphatic Drainage (MLD): A specialized hands-on therapy technique that follows lymphatic pathways to stimulate and open obstructed lymph structures.
Compression: At the conclusion of each MLD treatment, the therapist applies multiple layers of low stretch bandages (with appropriate padding) to prevent the affected limbs from refilling. Compression garments are ordered at the conclusion of treatment to support the integrity of the skin and maintain reduction of swelling.
Exercise and Nutritional Support: When needed, a registered dietician can offer suggestions about healthy eating and weight loss habits. The lymphedema therapists also offer specific exercise instruction to improve the body’s efficiency with fluid movement.
Hygiene and Topical Skin Products: Treatments that can help prevent infection, treat bacterial or fungal growth, or improve thickened skin are offered.
Education: The goal is to teach people to be independent with ongoing management of their lymphedema symptoms long after their last treatment session.
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What makes the treatment most effective?
Understanding lymphedema, its causes and the steps necessary to properly manage the symptoms is a considerable component of effective treatment outcomes. Consistent and diligent self management, weight control, and adherence to treatment protocol recommendations are necessary to achieving good long term results.
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Will therapy work?
Each person will respond differently to treatment. There are some factors that may hinder good treatment outcomes. These include, but are not limited to: poor weight control, an inactive lifestyle, inconsistent adherence to the treatment protocol.
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Will therapy cure lymphedema?
At this time, there is no cure for Lymphedema. However, it can be very successfully managed following timely diagnosis and appropriate treatment.
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How do I begin treatment at the Lymphedema Treatment Center at Mercy?
A referral/prescription from the patient’s physician is required prior to beginning the evaluation process. Our staff will contact the referring physician for additional information, such as a complete medical history and any pertinent test results needed to determine if a patient meets guidelines for treatment. In some cases, additional testing is requested to rule out conditions that may worsen with treatment.
Individuals are then scheduled for a 60-90 minute initial visit. This includes a review of symptoms, a physical assessment, baseline measurements of the affected area and discussion of treatment options and recommendations. Based on this assessment, an individualized treatment plan will be established and future treatment appointments scheduled.
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Will my insurance cover treatment?
We participate with most health insurance companies, health maintenance organizations (HMO) and Medicare. Patients should be aware that part of the cost of treatment may include compression bandages and/or compression garments in additional to the treatment sessions. We encourage patients to contact their individual insurance carrier(s) for benefit allowances.
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How will lymphedema affect my lifestyle?
Lymphedema is a condition that requires life-long management. Individuals at risk for developing lymphedema should educate themselves about risk factors, matters of prevention, and symptoms to be aware of. Left unmanaged, lymphedema is a progressive condition that worsens over time. This progression is often gradual and causes both cosmetic and physiological changes. Untreated lymphedema can result in progressive hardening of the affected tissues and skin, increased fluid volume, changes in skin appearance and texture, and an increased frequency of infections.
While in the initial treatment phase, individuals may feel their lifestyle is temporarily affected because of the treatment frequency and intensity often involved with lymphedema management. In the maintenance phase of lymphedema management, individuals may modify their daily routine to include lymphedema self care activities, but typically maintain their usual lifestyle and activities.
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Will other medical conditions affect lymphedema treatment?
The presence of certain medical conditions can make someone an unlikely candidate for lymphedema treatment. Generally these include acute infection, cardiac edema, renal dysfunction, acute deep vein thrombosis and some malignant diseases. Other conditions such as diabetes and obesity may also affect treatment outcomes.
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What about air travel and exercise with lymphedema?
Please click below for National Lymphedema Network Position Papers on these topics:Air Travel
Exercise
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