March is Lymphedema Awareness Month and healthcare professionals all over the country are taking the opportunity to promote greater understanding of this underserved medical diagnosis.
The lymphatic system, which is part of the circulatory system, is a network of vessels and ducts that move protein rich fluid throughout the body, filtering it through lymph nodes to remove cellular debris and toxins before returning it to the bloodstream.
There are two types of lymphedema: Primary lymphedema occurs when a person is born with a faulty lymphatic system and secondary lymphedema occurs when a person’s lymphatic system is damaged by, for example surgery, severe trauma, radiation or chemotherapy.
Lymphedema is a condition where excess high protein lymphatic fluid collects in the tissue spaces of the skin causing an abnormal swelling in a body part, such as the arm, leg, head and neck, genitals, chest, or back. A collection of protein rich fluid can create an inflammatory response, altering the tissue and creating fibrotic changes. Increased fluid and fibrosis can increase infection risk and reduce wound healing. In the U.S., lymphedema is most often encountered in the cancer patient population when lymph fluid flow is disrupted usually as a consequence of surgery (lymph node removal) or radiation.
Early detection of signs and symptoms of lymphedema is critical to successful management and will minimize complications of a more chronic condition. Signs to look out for include: persistent swelling; limb feeling full, heavy or achy; decreased joint flexibility; or clothing and jewelry start to feel tight. A tingling sensation may occur.
Treatment is intended to reduce limb size and reduce the risk of infection. It should be carried out by a skilled Certified Lymphedema Therapist. Therapy includes manual lymphatic drainage, compression bandaging, compression garments, decongestive exercises, and skin and nail care. Treatment also includes exercises to alleviate problems with joint mobility after surgery.
Here are some risk reduction practices to reduce your risk of developing lymphedema:
- Reduce infection risk by cleaning and moisturizing the skin.
- Avoid clothing that is too tight.
- Avoid excessive heat (saunas, hot tubs) or extreme cold.
- Avoid repetitive overuse of the at-risk limb – gradually increase activity level.
- Maintain a healthy diet and weight.
- Wear a compression sleeve or stocking as directed by your therapist.
- Avoid use of the at-risk limb for blood pressure measurements, blood draws and injections. Of note however, the positive effects of an injection intended, for example, to reduce pain can override any slim negative effects of a well-managed limb with lymphedema.
For more detailed information visit lymphnet.org.
Lymphedema is a controllable and manageable condition if treated early. Treatment is generally considered very safe and noninvasive, however anyone interested in this intervention should consult with their physician first for a prescribed treatment if appropriate.
Carol Long is an Occupational Therapist and Lead Certified Lymphedema Therapist for the Lymphedema Clinic at Sharp Metro campus located in the Allison DeRose Rehabilitation Center, 2999 Health Center Drive, San Diego, California. There, they have a state of the art bioimpedance device – the SOZO, which can assess for increased fluid in an at risk limb before it can be measured by conventional measurement devices. This allows the therapist to detect early onset lymphedema and begin treatment immediately. As well as treating patients daily, she runs a monthly Lymphedema Awareness Class for pre- and post-surgical patients considered to be at risk from Lymphedema. She has lived in Scripps Ranch for more than 10 years with her husband Gene and they have two sons. Their youngest attends Miramar Ranch Elementary and their oldest attends Marshall Middle School.