Compression Information

Lymphedema
What is Lymphedema?
Resulting from cancer treatment
Prevention and Management

Lymphedema is the swelling of a body part caused by abnormal accumulation of lymph fluid. Swelling can occur in various parts of the body. The most common parts of the body that it occurs in are the arm, leg, neck, or abdomen. Lymphedema is a chronic and progressive condition, but it can be brought under control through proper care.

Primary Lymphedema

Lymphedema can either be a primary condition or a secondary condition. The primary causes are unknown. Secondary (this means that it is a result of another condition)

Secondary Lymphedema

Lymphedema is caused by injuries or removal of lymph nodes. With the overabundant use of radiation therapy, many extreme cases of lymphedema in the United States have occurred. It is estimated that there are over two million cases of breast cancer in the United States alone. Radiation therapy which is one of the cures used, may cause lymphedema in later life.

As a result of cancer treatment:

Almost everyone who has been treated for breast cancer has lymph nodes removed, which may put you at risk for developing lymphedema.
Scarring of lymphatic vessels can constrict flow of lymph fluid.
Helmodynamic balances may have been disrupted, resulting in an increase in arterial flow and/or a decrease in venous return.
General deconditioning may occur, which further slows the lymphatic system from lack of movement.
Use of steroids may increase the lymph obligatory load throughout the body.

All of these factors can combine to produce a "bottleneck traffic jam" effect that prevents the removal of lymph fluid from your arm or leg. The larger porteins in the lymph fluid are not reabsorbed fast enough and remain in the soft tissue, attracting more water, which has more protein, which attracts more fluid.

As more and more lymph fluid becomes trapped, your limb swells. This swelling can cause pain, and make your limb heavy. It also can damage the health of your tissue because nutrients are blocked from reaching your tissue and waste products aren't able to be carried away. In severe cases, recurring infections, cellulitis, and thickening of skin may occur.

However, not everyone will get lymphedema. There are considerable variations in lymph vessel pathways, which enable some lymphatic systems to bypass the damaged area and function more efficiently than others.

Lymphedema has occurred as late as 22 years after breast cancer surgery of radiation treatment.
Between 15%-30% of women who have had breast cancer are expected to develop lymphedema as a result of current surgery and radiation treatments.
Lymphedema develops before swelling is noticeable. Aim to limit its severity. Be aware of the symptoms that may already be present. (See below)
Lymphedema treatment is time-consuming, expensive and only some what effective. Delaying onset, reducing severity and avoiding infection are the goals.

Monitor for signs of Lymphedema

1. Symptoms to look for: Does your affected side feel:

heavy	hot	tired	ache	throb
pressurized or swollen from the inside out? As if there is a golf ball or a baseball in your armpit, chest or back area? Like a rotor-rooter has torn the area apart?

2. If any of these symptoms occur, immediately:

Stop what you are doing

elevate at-risk arm to increase the flow of lymph fluid

Check for signs of swelling, cuts,etc.. and

Self-massage. See "Gentle self-massage for Your Affected Arm...." below

3. Tendon Check:

Compare your hands. Look between your knuckles. Is the at-risk hand fatter

4. Elbow Check:

Compare your elbows in the mirror. is your at-risk elbow fatter?

5. Using a measuring tape to establish the base size of both of your arms at the three areas indicated.

Circle the month you begin. Measure your affected arm each month. Document any changes.

Unaffected Arm size:

Affected Arm Size:

___________
Third Finger

Jan	Feb	Mar.	Apr.	may	June	July	Aug.	Sept.	Oct.	Nov.	Dec.
-	-	-	-	-	-	-	-	-	-	-	-
-	-	-	-	-	--	-	-	-	-	-	-
-	-	-	-	-	-	-	-	-	-	-	-

___________
Watchband area

___________
Elbow Crease

Prevention and Management

Gentle Self-Massage for Your Affected Arm to Improve the Drainage of Lymphatic Fluid

Apply enough pressure to cause the skin to move slightly. If you glide over the surface of the skin, your touch is too soft. If your skin becomes red, you are applying too much pressure:

Raise your affected arm in the air, palm facing you.
Use your other hand to gently stroke your affected arm from the back of your hand downward toward the back of your shoulder.
Continue the stroke sweeping down along the side of your body to just above your hipbone.
Sweep in front, down and over to just below your navel into the groin area.

Repeat the downward stroking beginning from the palm side of your arm down, across, and to the back of your armpit.
Continue the stroke sweeping down along the side of your body to just above your hipbone.

End Position:

Sweep down and over to just below your navel moving the lymph fluid into the unaffected lymph nodes in your groin area.

Repeat 3-5 times per self-massage session

The most logical way to treat lymphedema is to use Complete Decongestive Physiotherapy (CDP). CDP involves 4 steps.

Hygiene and topical skin products to eliminate bacterial and fungal growth by using low pH lotion click here for more information
Manual Lymph Drainage (MLD), a special lymphatic decompressive form of physiotherapy. click here for more information
Bandaging and compression using a specially designed bandage and/or compression sleeve to be used after MLD to create necessary pressure on the limb.click here for more information (click here to read a study on the effectiveness of compression pumps)
Remedial exercises and elevation with the bandages and/or sleeves, taught to the patient.click here for more information