Understanding Lymphedema - Part 2

In this edition of the Understanding Lymphedema series, I pick up where I left off in my last post, with an outline of what to if you experience symptoms of lymphedema and treatment protocols.

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What to do when you experience Lymphedema Symptoms 
 
Do not hesitate to seek out medical attention from a doctor or lymphedema therapist if you experience any of the signs of lymphedema listed in the Part 1 of this series and/you notice any of the following changes:

• A part of your body begins to feel hot, looks red, has red blotches or streaks, is tender or sore when touched, or swells suddenly. These could be a sign of infection or a blood clot, and you might need treatment right away.
• You develop a temperature of 100.5°F/38°C or higher (taken by mouth) that’s not related to a cold or flu
• New pain in the affected area with no known cause

 
Making sure that you get treatment early on, will lead shorter courses of treatment to get your lymphedema symptoms under control. So, get help as soon as possible once you notice symptoms.
 
 
Treatment

It is important to note that there is no cure for lymphedema. As a result, once a diagnosis of lymphedema is confirmed, your doctor or therapist will recommend treatment protocols that will help to reduce any swelling you may experience and/or maintain any reductions achieved. For the vast majority of patients, Combined Decongestive Therapy (CDT) applied by a skilled lymphedema therapist is the safest, most effective and non-invasive form of treatment to manage their symptoms. CDT treatment involves the following five components:
 
Manual Lymph Drainage
This is a relatively gentle, non-invasive manual technique that reroutes accumulated fluid in congested (swollen) areas of the body toward healthy, functional lymphatic pathways. During the application of this technique, the skin is stretched and torqued in a very specific manner, encouraging heightened lymph flow. When performed correctly, the technique greatly enhances recovery and facilitates drainage. 
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Graduated Compression Garments
Bandages and/or compression garments (i.e. stockings or arm sleeves) provide external pressure to assist lymph drainage and ideally prevent further swelling. Although an incidence of swelling may be reversible, in most cases it is not completely so and generally leads to chronic swelling. Compression therapies are most often used by people who have already been diagnosed with lymphedema; however, if you are at risk for lymphedema, choosing wear a compression garment will decrease your chances of developing symptoms.
 
If you are showing signs of the onset of lymphedema and you do not yet have a compression garment, it is recommended that you see a lymphedema therapist who will assess you to determine if you are a candidate for bandaging, a fitted compression garment (i.e. sleeve or stocking), or a compression wrap. In the case of fitted compression garments, it is very important that you are properly fitted by a certified fitter, as using a poorly-fitting compression garment may increase your risk for lymphedema or make your symptoms worse.
 
It is important that you follow your lymphedema therapist’s recommendations for wear and care of your garment. In most cases, this will mean wearing your garment during your waking hours, while you are active (as repetitve motions, such as those performed while cleaning, doing yard work or exercising can increase swelling in the affected area), and removing it at night when you go to sleep. Wearing a garment is also important during air travel, as the decrease in cabin pressure in a plane puts stress on the lymphatic and circulatory systems, which can increase swelling.  
 
Some insurance companies will pay for lymphedema compression garments, so check with your insurance company or talk to your lymphedema therapist about getting authorized for funding to cover the cost of your garments through Ontario’s Assistive Devices Program.
 
Meticulous Skin Care
As the skin inevitably thickens in lymphedema, making it stiffer and less malleable, promoting the hygiene and health of the skin is important to prevent degradation and infection – particularly cellulitis. Therefore, lymphedema patients should do their best to maintain a good skin care regimen, which includes:
 

1. Inspecting the skin daily for any crack, cuts or dry areas. Be sure to carefully check areas with reduced sensation or where there are skin folds.
2. Clean skin daily with non-perfumed soap.
3. Dry skin completely, especially the area between the toes.
4. Keep skin supple. Moisturize with a low pH lotion (i.e. Eucerin, Curel, Dermaltherapy, Johnson & Johnson baby lotion, or Lymphoderm) 
5. Check fingernails and toenails for any signs of infection, cracks, fungus, or hangnails. Do not cut nails or cuticles. Use an emery board.
6. Call your doctor at the first signs of any infection, redness or temperature.

 
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Education:
 
Lymphedema therapists provide their patients with knowledge and resources on how to prevent, manage and/or successfully cope with their symptoms, in order to improve their quality of life. They will teach also you about self-massage to manage your symptoms between treatments, exercise, and many other self-care tips. 

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