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Hands Embracing

Lymphedema

Lymphedema is a chronic swelling of an extremity or part of the body caused by a deficiency in the flow of lymph fluid from the area due to:

  • Surgical removal of lymph nodes (i.e. mastectomy or prostate surgery).
  • Congenital (born with) defect of having too few or impaired lymphatics or lymph nodes.
  • Destruction of extensive lymphatic pathways due to trauma, surgery or radiation.

Symptoms of Lymphedema
  • Swelling of the extremities, trunk or face, ranging from minimal to extreme.
  • When pressing a finger to the swollen area, the indent lasts several seconds before returning to normal.
  • Tissue may be so hard you can't indent.
  • Sometimes tissue has a slightly blanched color where fluid is most congested.
Causes

Lymphedema can develop at any time – months or even years – after surgery, injury and/or radiation. Often it is triggered by a new injury or trauma to the extremity. Approximately 32 percent of patients who have had lymph nodes removed and radiation will develop Lymphedema.

Injury, infections, rashes and inflamed muscles all cause the body to send extra healing fluid to the area. The extra fluid overloads the system, causing a slowing in the movement of lymph fluid. As the lymph fluid and tissue waste products collect, the extremity swells and hardens. Bacteria in the fluids can multiply and infection can spread rapidly.

Minimize Your Risk

Avoid even minor rashes, burns or wounds because the body will respond by sending extra fluid to destroy bacteria, heal tissue, etc. causing swelling to increase. Seek medical attention immediately if you develop an infection in the involved extremity/area. Avoid heavy pressure on the "net like" lymphatic pathways that drain tissue fluid. Pressure will collapse lymphatics and cause fluid backup. 

Other tips include:

  • Pad bra straps to prevent indents.
  • Keep sleeves, socks, watch bands and jewelry loose. Avoid rings.
  • Wear long oven mitts to avoid burns.
  • Use sunscreen to prevent burns and insect repellent to avoid bites or stings.
  • Use moisturizing lotion to keep skin from drying/cracking.
  • Use a thimble to avoid skin puncture.
  • If planning a plane trip, have a trained therapist suggest a few pointers.
  • Carry a shoulder strap purse on opposite shoulder or use a "fanny pack."
  • Do not allow blood to be drawn from the extremity.
  • Do not allow a blood pressure cuff to be placed on the involved extremity.
Treatments

Although there is no cure for lymphedema, the condition can be significantly reduced and controlled with therapy and self-management.

Early intervention is the most effective. Persons with mild to severe lymphedema need formal treatment provided by an occupational or physical therapist certified in lymphedema treatment.

At Fisher-Titus Medical Center's Rehabilitation Center, a Certified Lymphedema Therapist will direct your care and will be your primary therapist during treatment.

Treatments include:

  • Specialized gentle massage to reroute and remove the fluid
  • An exercise program
  • Pneumatic pump
  • Compression bandages and/or sleeve
  • Wound and skin care
  • Lifestyle adaptations (if needed)
  • Special sessions in precautions and self-management of the involved extremity

A physician referral is required to begin treatment.*

*Medicare generally covers 80 percent of your therapy and it also is covered by most private insurance. Check with your insurance carrier for specific plan coverage.