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Lymphedema

Lymphedema is an abnormal accumulation of protein-rich fluid in the interstitium, most frequently seen in the arms or legs. It is a chronic condition but can be controlled.

Primary vs. Secondary Lymphedema

Primary Lymphedema develops due to imperfect development of the lymph vascular system. This can occur at birth or often appear later in life.

Secondary Lymphedema has a known cause such as destruction or removal of lymph nodes related to surgery and radiation for Cancer, Filariasis (elephantiasis), obesity, severe trauma or infection.

Usual Signs and Symptoms

Discomfort – feeling of heaviness, tightness and the feeling of tension.

Symmetry – if bilateral, Lymphedema is usually assymetrical.

Skin changes – swelling, tissue hardening or thickening and hyperkeratosis, papillomas if left untreated.

Stages of Lymphedema

Stage 0 – Latency – Patient may have subjective complaints/symptoms.

Stage 1 – Reversible – Pitting and reduces with elevation

Stage 2 – Spontaneously irreversible – displays evidence of fibrosis

Stage 3 – Lymphostatic elephantiasis – Severe edema with severe skin changes

How to manage Lymphedema

Manual Lymph Drainage (MLD) – increases lymphangio activity used to reroute fluid around blocked area into healthy lymphatic regions and lymph nodes. It promotes relaxation and reabsorption of protein-rich fluid.

Compression Bandaging – prevents re-accumulation of fluid and assists in the breakdown of deposits of indurated tissue. Compression alone does NOT adequately treat Lymphedema. Compression therapy without MLD can lead to proximal edema and fibrosis of the adjacent trunk quadrant.

Exercise – to facilitate lymphatic and venous return, it should be done at a moderate level while wearing compression garments.

Skin care – To decreased incidence of infection. And do not forget to moisturize your skin.

Eat a balanced healthy food – Weight management is important to patient’s with Lymphedema.