Lymphedema Care
What is Lymphedema?
Lymphedema is an accumulation of a protein-rich fluid that develops when there is impairment to normal lymphatic flow. This fluid accumulates in the subcutaneous tissues and causes swelling. Lymphedema is most commonly seen in the extremities, but can also be present in the abdomen, head/neck and genitalia.
Lymphedema is a chronic and progressive condition. There is no cure but lymphedema can be managed. Swelling ranges from mild, with hardly noticeable changes in the size of your arm or leg, to extreme, making it difficult to use the affected arm or leg. With increased swelling, skin can become tight, dry and fragile. The subcutaneous tissues can become firm and cause discomfort.
What causes Lymphedema?
Common causes include lymph node dissection or radiation treatment. Other common causes of lymphedema include:
- Cancers such as breast, bladder, gynecological, colon, prostate, testicular, skin or esophageal
- Surgery with lymph node removal
- Radiation treatment
- Cellulitis infections
- Post-surgical swelling, such as hip or knee replacement
- Diabetes, diabetic ulcers
- Chronic venous insufficiency
- Deep vein thrombosis (DVT)
- Lipo-lymphedema
Signs/symptoms of lymphedema
- Swelling of part of or entire arm or leg; can also be present in the chest, abdomen, genitals or face
- Feelings of fullness, heaviness, tightness in the arm or leg
- Discomfort, aching or fatigue of the affected area
- Hardening or thickening of the skin of the affected area
- Recurring infections in the affected area
- Weakness in the affected arm or leg
Treatment
- A certified lymphedema therapist (CLT) will complete an assessment and develop a care plan.
- Treatment involves Complete Decongestive Therapy (CDT), which is a non-invasive, safe and effective way to reduce the swelling in the extremity. CDT consists of the following components.
- Manual Lymph Drainage (MLD) — A gentle manual treatment to re-route lymphatic fluid to healthy areas. When applied correctly, limbs can be reduced to near-normal size.
- Compression Therapy — Applying compression to the extremity helps prevent re-accumulation, as well as improving muscle pumping and reducing fibrotic tissue.
- Exercises — When completed while wearing compression bandages, exercise improves muscle pump activity. Vigorous exercise should be avoided.
- Skin care — The skin involved in lymphedema is usually dry and is at increased risk for infections. A low-pH lotion, free of fragrances and alcohol, helps maintain skin moisture and avoid infections.
- Patient education – You are taught how to manage swelling and prevent re-accumulation of swelling.
In addition to lymphedema therapy, MCC occupational therapists can assist with other common side effects of cancer treatment:
- Improve range of motion
- Decrease muscle tightness
- Improve scar mobility
- Improve upper body strength
- Education on energy conservation techniques
- Improve mobility
