Lymphedema

Lymphedema is a condition of localized fluid retention caused by a compromised lymphatic system. The lymphatic system collects and filters the interstitial fluid of the body. Lymphedema has been barely recognized as being a serious health problem; however, this is slowly changing due to education and awareness. The danger with lymphedema comes from the constant risk of developing an uncontrolled infection in the affected limb. Still, physicians and medical staff who practice in fields where this disease is uncommon may fail to correctly diagnose the condition due to the apparent lack of information regarding this disease.

Lymphedema may be inherited or caused by injury to the lymphatic vessels. It is most frequently seen after lymph node dissection, surgery and/or radiation therapy, in which damage to the lymphatic system is caused during the treatment of cancer, most notably breast cancer. In many cancer patients this condition does not develop until months or even years after their therapy has concluded. Lymphedema may also be associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly. In tropical areas of the world, a common cause of secondary lymphedema is filariasis, a parasitic infection.

While the exact cause of primary lymphedema is still unknown, it generally occurs due to poorly-developed or missing lymph nodes and/or channels in the body. Lymphedema may be present at birth, develop at the onset of puberty, or not become apparent for many years into adulthood. Some cases of lymphedema may be associated with other vascular abnormalities. In the lower extremity it will be unilateral or bilateral. If it is bilateral, one leg may be worse than the other.

Symptoms may include severe fatigue, a heavy swollen limb or localized fluid accumulation in other body areas, discoloration of the skin overlying the lymphedema, and eventually deformity.

The treatment of choice for lymphedema is Complete Decongestive Therapy (CDT). CDT consists of manual lymphatic drainage (MLD), short stretch compression bandaging, therapeutic exercise, and skin care. MLD was pioneered by Dr. Emil Vodder in the 1930s for the treatment of chronic sinusitis and other immune disorders, and is now recognized as a primary tool in lymphedema management. Therapists can today receive certification through special classes conducted by various organizations specializing in MLD.

The MLD component of treatment consists of gentle, rhythmic massaging of the skin to stimulate the flow of lymph and its return to the blood circulation system. In the blood’s passage through the kidneys, the excess fluid is filtered out and eliminated from the body through urination. The treatment is very comfortable and nonaggressive. A typical session will involve drainage of the neck, trunk, and involved extremity, and lasts approximately 40 to 60 minutes, depending on the severity and extent of the lymphedema.

Compression bandaging, also called wrapping, is the application of several layers of padding and short-stretch bandages to the involved areas. Short-stretch bandages are preferred over long-stretch bandages, as the long-stretch bandages cannot produce the higher tension necessary to safely reduce Lymphedema and may in fact end up producing a tourniquet effect. During activity, whether exercise or daily activities, the short-stretch bandages enhance the pumping action of the lymph vessels by providing increased resistance for them to push against. This encourages lymphatic flow and helps to soften fluid-swollen areas.

...More at Wikipedia

Related Links:

• National Lymphedema Network
• Society for Vascular Surgery
• Mayo Clinic

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