What is Lymphedema? Lymphedema is swelling (edema), most often affecting an arm or a leg, caused by the abnormal accumulation of lymph fluid in the fatty tissues just beneath the skin. It can also occur in the face, neck, chest, breast, abdomen, groin and lung.
In North America, Lymphedema is still a relatively unknown condition that medical personnel often misdiagnose. Even in the rare cases, when it is correctly diagnosed, people living with this condition are often told that they must learn to live with the symptoms, because there is no treatment. Furthermore, the solutions offered by traditional treatment methods are generally temporary and in most cases, only serve to make the symptoms of the condition worse.
Fortunately, via Combined Decongestive Therapy treatment protocols, Lymphedema and its symptom can be brought under control. Although it is a chronic and progressive condition, Lymphedema can be compatible with a normal and active lifestyle.
Primary or Secondary Lymphedema Diagnoses of Lymphedema are characterized as either a primary or secondary. Primary Lymphedema conditions are those that occur without any obvious cause. They may be present at birth or occur later in life. Some cases have a family history of the condition.
In the case of Secondary Lymphedema, injury, scarring or removal of the lymph nodes, is usually the cause. However, less frequently, trauma to or chronic infections of the lymph vessel system bring on the condition. In North America, previous radiation and/or surgery of the lymph nodes in the neck, armpit, pelvis or groin – during the treatment of cancers of the breast, uterus, bladder, ovary, prostate or testicles, as well as malignant melanomas, sarcomas and lymphomas – are common causes.
Treatment for Lymphedema Lymphedema is a serious condition, which indicates that the lymph vessel system is unable to handle the lymph load. As it is a progressive condition, ideally Combined Decongestive Therapy treatment protocolsshould begin soon after diagnosis. Notably, for Secondary Lymphedema cases it may be prudent to start treatment before diagnosis or the development of symptoms, to prevent swelling from occurring after radiation and/or the removal of lymph nodes.
Exercise is beneficial as long as you are not doing too much. The affected limb or body part shouldn’t ache with tiredness after exercise
Interval training is best – short periods of one activity, alternated with others
Wear a compression garment or bandage while exercising to encourage the extra blood flow that results from exercise to move back to the heart
Listen to your body during exercise and afterwards. If your affected body part is larger or more painful after exercise, you have done too much
During the summer or in hotter climates ideally, any and all outdoor exercise should be done early in the morning or in evening
Perform self-massage before and after exercising
When using weights start with a very light weight and then slowly increase the amount you are lifting in small increments (i.e. ½ or 1lb). Start with 2 sets of 10 reps, and increase to 3 sets of 10 reps maximum with one weight, before choosing a heavier weight. If you notice more swelling after increasing either the weight or number of sets during your workout, return to the previous level where no swelling occurred for the following workout
Preventing and managing lymphedema symptoms, such as swelling, aching and feelings of heaviness, is all about finding balance. If you’re living with lymphedema, achieving fluid balance is much like balancing your finances. When you spend more than you have, you will be in the red. As the equation below illustrates, if the demands on the lymph vessel system outweigh its capacity, then swelling occurs. (N.B. Because the demand on your lymph vessel system is based on the sum total of all your daily activities, you will rarely be able to pinpoint one particular activity as the cause of any new symptoms or increased swelling you experience.)
Demand – Capacity = Degree of Symptoms
For example, if there is a demand of 200ml of fluid/day to be returned to the heart, but only a capacity of 180ml of fluid/day within the lymph vessel system, then 20ml of fluid will be left behind in the affected tissues each day, resulting tissue swelling.
200 – 180 = 20ml of swelling
However, if the demand is reduced OR the capacity increased, the result would be no swelling. For example, with a demand of only is 170ml of fluid/day in the scenario above, there would be a reserve of 10ml.
170 – 180 = -10ml (reserve)
Similarly, if the capacity of the lymph vessel system is increased to 210ml of fluid/day, a 10ml reserve would also be the result.
200 – 210 = -10ml (reserve)
When managing or trying to prevent lymphedema, your aim is to have no additional or new symptoms. Essentially, the goal is to achieve a reserve or have a balance of zero within your lymph vessel system by becoming aware of what makes your symptoms better or worse, and taking steps to balance these factors. Finally, it’s worth noting that managing increased swelling is always easier when it’s a small amount. If the increase in swelling is significant, greater measures are needed to return to balance.
The lists to follow provide an outline of things that may:
Trigger or worsen lymphedema symptoms, by increasing the demand on the lymph vessel system; or
Prevent or improve such symptoms by increasing the capacity of the lymph vessel system.
Things That May Improve Lymphedema Symptoms (Decrease Demand on the Lymphatic System)
Gradually and routinely building up the duration and intensity of any activity or exercise
Changing activities frequently to avoid too much repetition for any affected areas (e.g. vacuuming one room at a time, not the whole house)
Avoiding strenuous activities that you have not prepared for or regularly participate in (i.e. joining a gym and overdoing it on the first day or lifting heavy loads when you are not accustomed to it)
Self-massage done at the start or end of each day to help the affected area "catch up". It may also be a good idea to do throughout the day to decrease congestion in any areas that are having more difficulty
Using visualization to stimulate the lymph vessel system
A consistent skin care regime, including daily use of good moisturizing lotion
Compression garments to help support the limb return lymph to the heart instead of allowing it to pool in the tissues.