Lymphedema

What is Lymphedema?

Lymphedema is a swelling that occurs from an abnormal accumulation of protein rich fluid in the space between cells in the body which can advance to chronic inflammation and fibrosis of affected tissues. Lymphedema may occur days, months, or years after cancer surgery or at the onset of obstruction of the lymphatic system. There is no cure for Lymphedema, only management.

There are 2 basic forms of Lymphedema:

  • Primary Lymphedema which may be present at birth, but it more often develops later in life without obvious cause.
  • Secondary Lymphedema which is the most common, and is most likely the result of surgical removal of the lymph nodes due to cancer. Secondary forms may also occur after injury, scarring, trauma, chronic venous insufficiency or infection of the lymphatic system.

Other reasons people can develop lymphedema:

  • Lymph node removal for cancer treatment
  • Filariasis
  • Cancer (a tumor)
  • Trauma
  • Infection
  • Chronic Venous Insufficiency
  • Obesity

 


 

How is Lymphedema Treated?

Lymphedema is treated with Complete Decongestive Therapy (CDT).

TREATMENT (PHASE I) AND INDEPENDENT SELF CARE (PHASE II)

Treatment usually consists of:

  • Meticulous skin and nail care
  • Manual lymph drainage – specialized manual techniques to move the fluid
  • Compression bandaging – with short stretch bandages that have a high working pressure and a low resting pressure
  • Remedial exercises – increasing lymph drainage by activating the muscle pump
  • Self care training – instruction in independent management

The appropriate treatment for lymphedema requires the identification of limitations. These limitations include: severity of the condition, barriers to treatment secondary to work/ insurance, physical capability of the patient in self-management of the lymphedema, restrictions (such as high blood pressure), and availability of family.

Treatment Duration: 2-12 weeks depending on the severity of the lymphedema. Patients are encouraged to start on a Monday so that the full week can be used prior to the weekend.

Treatment Frequency: 2-5 times a week depending on severity of the condition along with any insurance constraints that may be placed on the patient’s visit pattern.

WHAT TO BRING?

Your therapist will let you know whether or not you need to order compression bandages. Please be aware that MEDICARE (and many other insurances) DO NOT COVER BANDAGES OR GARMENTS (or cover them only partially). You may be financially responsible for these supplies, but most suppliers are willing to work with you on a payment plan. Also, the American Cancer Society provides a voucher for those who have lymphedema secondary to cancer. Their number is 1-800-ACS-2345.

Where to obtain bandages? There are a few suppliers in the area that supply short stretch bandages and the rest of the compression supplies. The therapist will decide on the proper amount of supplies that need to be ordered and then will fill out an order form, fax it to the supplier, and give you a copy. If your insurance does not cover the bandages you will be financially responsible and the supplier will contact you to let you know the cost. You will not receive the bandages until the supplier receives payment.

What should you wear to your treatment session? LOOSE FITTING CLOTHES to accommodate the bandages. If you are going to have your leg bandaged, bring a loose fitting tennis shoe or one that is a 1⁄2 size larger. A sandal with a Velcro strap across the front and open in the back also works well.

Lymphedma Therapy is also available through OSPTA Home Health & Hospice. For more information, please call 1-866-483-4859 or click here.