Lymphedema is a condition that results in the breakdown of the body’s ability to remove and filter intercellular fluids. The result is an excessive accumulation of lymph, the fluid that originates in the spaces between body cells. Lymph normally flows into a successively larger series of vessels deeper in the body and is eventually emptied into the venous system. Hundreds of lymph nodes stationed throughout the body filter out proteins, micro-organisms, body cell wastes, and other waste particles too large for the veins to transport.
Most people know very little about lymphedema, how and why it occurs or what can be done about it. This not only includes people affected with lymphedema but also those healthcare professionals who come in contact with them. Patients in the USA who develop lymphedema do so most frequently as a result of prior cancer treatment for breast cancer, melanoma, cervical cancer, removal of lymph nodes, or radiation for tumors. This is secondary lymphedema. The most extreme form of secondary lymphedema is elephantiasis. Elephantiasis is characterized by tremendous swelling; the overlying skin is very dark in color, thick and course, resembling an elephant’s hide. Elephantiasis can develop after long periods of untreated lymphedema. Still other cases of lymphedema develop as a result of burns, trauma from surgery, accidents, cuts or breaks in the skin or even insect bites. There are also large numbers of people born with this condition – this is primary lymphedema.
Very little in the way of therapy has been available to relieve both the physical and emotional distress brought on by this condition. One of the problems of lymphedema is that is does not remain stationary – it continually progresses. Untreated lymphedema can result in grossly swollen body parts containing areas of stagnated lymph leading to fibrosis: hardening of the tissues and loss of skin elasticity. Because this lymph fluid is protein-rich, it is a perfect medium for growth of bacteria, and the area/limb becomes highly susceptible to infection and cellulitis. Any break in the skin can open the way for bacteria to enter. Furthermore, severe swelling and fibrosis leads to immobility due to increased swelling in the joints; chronic infections because of stagnation of wastes in the tissues of the affected part, and irreversible complications.
Untreated lymphedema can result in grossly swollen body parts, immobility, chronic infections, and a cancer known as lymphangiosarcoma. And since lymphedema is a chronic disease, it requires proper treatment and maintenance to control swelling, prevent complications, and increase quality of life.
Those most severely affected are children with primary lymphedema. Many of these children have an accompanying congenital disease known as Klippel-Trenaunay, which not only affects body tissues, but also blood vessels and bones. The resulting effects are port wine stains with severe varicose veins, swollen bulbous tissues, especially of the feet and toes, and unequal bone growth of the legs. Treatment includes not only combined decongestive therapy and other usual methods, but also custom gradient compression garments and specially made shoes. Since each lymphedema case is different, these children, as well as all lymphedema patients, will have lymphedema the rest of their lives, will always have special needs and must be treated individually, or case specific.
- Prickly, burning, or itchy sensations in a suspected area
- A heavy or achy feeling; skin feeling tight and full
- A ring, watch, or bracelet becoming too tight
- A tight sensation in a hand or foot
- Clothes not fitting in a certain area
- Increased swelling in an area that sometimes recedes at night but returns, as the body is vertical for a long period of time
- Persistent swelling & skin that pits with finger pressure
- Decreased flexibility, especially in the knee, elbow, ankle, or wrist
- Combined Decongestive Therapy (CDT)
- Gradient compression garments
- Circumferential measurements of affected body part
- Intense skin care
- A nutritional and fluid intake regimen
- Specific exercises with compression
- Water therapy
- Supportive shoes
- Manual lymph drainage
- Gradient sequential pneumatic pumping device
- Gradient bandaging
- Directional flow garment
- Keeping active and a positive enhancing life support
- surgery, lymph nodes removed + radiation, you have a 55 – 65% chance of getting lymphedema
- surgery alone, you have a 10 – 15% chance
- surgery + lymph nodes removed, you have 25 - 30% chance
- and it can occur anytime.
- Medical professional with solid background in anatomy & physiology of the lymphatic system
- Completion of 140 hours of education in the field of lymphology/lymphedema
- Approximately 300 hours of practicum
- Five (5) years’ experience in the field of lymphedema treatment and care
- Pass the LANA test to become an Internationally Qualified Lymphedema Therapist