Lymphedema
is an imbalance between the normal amount of protein load and the reduced
transport capacity of lymph vascular system. This can result in an accumulation
of lymphatic fluid in the interstitial tissue that causes swelling. This swelling
occurs most often in the arms and legs but can occur in other body parts as
well.
Causes:
- Can develop
as a result of surgery, radiation, infection, or trauma
- Can develop
immediately post-operatively, or weeks, months, and even years later
- Can occur from
congenital malformations of the lymphatic system
- Can occur when
lymph vessels are damaged or when lymph nodes are removed
- Can occur from
unknown causes
Symptoms:
Lymphedema can
develop in any part of the body or limb(s), with the following symptoms:
- A full sensation
in the limb(s)
- Skin feeling tight
- Decreased flexibility
in the hand, wrist or ankle
- Difficulty fitting
into clothing in one specific area
- Ring, wristwatch
or bracelet tightness
Stages:
- Latency Stage
- no swelling, reduced transport capacity, "normal" consistency
- Stage I (reversible)
- edema is soft/pitting, no secondary tissue changes, elevation reduces swelling
- Stage II (spontaneously
irreversibly) - fibrosclerotic changes, hardening of the tissue, difficult
to achieve pitting, frequent infections
- Stage III (lymphostatic
elephantiasis) - extreme increase in volume and texture with typical skin
changes
Treatments:
Complex Decongestive Therapy (CDT) is:
- Manual lymphatic
drainage
- gentle manual soft tissue technique/treatment that stimulates the lymphatic
structure to increase lymph flow and improves the activity of intact lymph
vessels
- Compression
bandaging
- applied to increase tissue pressure and counteract the elastic insufficiency
of the connective tissue
- Proper skin
care & diet
- Compression
garments
(sleeves, stockings)
- Remedial exercises
- Self manual
lymphatic drainage & bandaging,
if instruction is available
- Follow through
with prophylactic methods at all times
Phases of Treatment:
- Phase I
- mobilizing
the accumulated protein-rich fluid and initiating the reduction of fibrosclerotic
tissue
- occurring
daily, 1.5 hours/day, five days per week, for average length of three
to four weeks
- instructing
client in techniques designed to maintain and improve the success of the
treatment
- Phase II
- aiming to
preserve and to improve the success in phase one
- continuing
program in client's home
Therapists' Training:
Sarah Tanner, Registered
Occupational Therapist, completed 135 hours of intensive training through the
Academy of Lymphatic Studies in San Francisco, California. In 2001, Sarah became
a Certified Decongestive Therapist through the Lymphology Association of North
America (CDT/LANA). This training was funded by Rice Memorial Hospital Auxiliary
and Willmar Cancer Center.
For More Information:
Check out the National
Lymphedema Network Site.
For more information
on the Lymphedema clinic at Rice Rehab:
lsti@rice.willmar.mn.us or (320)
231-4175
