SHEDDING LIGHT ON LYMPHEDEMA

 11 Alive Community Service Award Winner - Joan White

Formal program was at the Hyatt Regency, Atlanta, GA, April 3, 2008

Lighthouse Lymphedema Network  (LLN) Founder  and Current Director

 WHAT IS LYMPHEDEMA?

     Lymphedema is the swelling of a human body part caused by an abnormal  accumulation of fluid, proteins, and cellular waste in the tissues under the skin.  It occurs when there is a problem in the lymphatic system:

The failure of lymph vessels to develop properly

Damage to lymph vessels by trauma, surgery, or infection

Removal or destruction of lymph nodes, usually during treatment of cancer

      Lymphedema can be a painful and disfiguring condition.  It can lead to decreased mobilily, repeated episodes of infections (cellulitis, erysipelas, lymphagitis), and mental depression. It can require constant and chronic medical care and expense.  Severe cases involve thickening of the skin, hardening of the tissues (fibrosis), leaking of fluid, massive swelling and skin changes such as warty growths.  The extreme version of lymphedema is called elephantiasis when the limb becomes enormous and distorted, with drastic changes in the skin and tissue.

 THE LYMPHATIC SYSTEM

 
     The  lymph system consists of a network of lymph vessels traveling to lymph nodes carrying lymph fluid.  The lymph vessels are located all over the body, usually next to veins. They transport lymph fluid - the excess fluid in the tissues which is filled with proteins, white blood cells, germs, and cellular waste products.  This lymph fluid is carried up to the lymph nodes where it is filtered and detoxified before being returned to the blood stream.
     You have 500-1000 lymph nodes located all around your body:
 
          >    The neck (supraclavicular and cervical)
          >    The armpits (axilla)
          >     Along the windpipe (trachea)
          >     Adjacent to the lung (bronchial)
          >     In the chest cavity (thoracic)
          >     Along the intestine (abdominal)
          >     Behind the abdominal cavity (retroperitoneal)
          >     The pelvic area - The groin area (inguinal)
 
          Lymph tissue is also found in the tonsils, spleen, intestinal wall and bone marrow.
 
WHAT CAUSES LYMPHEDEMA?
 
     Primary Lymphedema usually appears without obvious cause or after a minor traumatic event or an infection. It can happen at any age, but is often due to a congenital abnormality, usually involving malformation or non-formation of lymph vessels.
Secondary Lymphedema is an acquired condition resulting from the loss of obstruction of previously normal lymph pathways have been removed or damaged.  It often occurs after a surgical procedure where lymph notes or lymph vessels have been removed or damaged. Surgery and/or radiation from cancer treatment is one of the most common causes.  People who have had treatment for breast cancer, melanomas, prostate cancer, ovarian, cervical, or uterine cancer, or lymphomas are all at risk, although the swelling may not appear until months or even years later.  The rate of progression of lymphedema varies with temperature, humidity, activities and the number of infections and complications.
     In the case of arm lymphedema after axillary surgery of radiation therapy (or both) the lymphedema is often more distressing to the person than the mastectomy or lumpectomy because the person must deal with lymphedema and it complications for life.
     In the legs, lymphedema is more distressing, because people must deal with a variety of special problems, such as a different shoe size for each foot, difficulty walking, excessive fatigue from heavy lower extremities, back pain, diminished agility, feeling forced into a sedentary lifestyle.
 
TREATMENT FOR LYMPHEDEMA
 
     Lymphedema is not curable (at this time), but it is controllable. It can be compared to Diabetes from the standpoint of being a chronic disease or condition.  The aim of treatment is to improve appearance, increase function, and prevent further progression of swelling. Treatment should begin as soon as lymphedema is diagnosed. If left untreated, lymphedema can result in irreversible damage.  However, treatment can be effective even for people who have had lymphedema for many years.
    
     The best and most effective treatment for lymphedema is Complete Decongestive Therapy (CDT) which has five major components: 
  1.  Manual Lymphatic Drainage (MLD) is a gentle message-like technique.  It opens the collateral lymphatic pathways to move the  excess fluid to areas where the lymph system is functioning normally.
  2.  Compression Therapy such as bandaging and garments are an essential component of lymphedema management.  Keeping the limb wrapped in a multi-layer low stretch bangage during treatment can decrease the excess fluid and help to soften the tissues.  After treatment, a strong gradient compression stocking or sleve can help maintain results.
  3.  Exercise such as swimming and walking according to recommended CDT protocols can help stiumlate the lymphatic system and keep the fluid moving and prevent fluid pooling.
  4.  Meticulous Skin and Nail Care is critical to the affected limb to avoid skin cracking and infections.  Using low pH soaps and lotions can help protect against pathogenic bacteria and skin drying. 
  5. Excellent Nutrition is also important.  Avoid fatty foods and salt.  Eat lots of fresh fruits and vegetables.  Controlling you weight is necessary because studies have found that obesity aggravates lymphedema.  Avoid excessive use of caffeine, nicotine, and alcohol. 
 
 
DIAGNOSTIC TEST FOR LYMPHEDEMA
 
Lymphoscintigraphy is the "gold standard" for evaluating lymphedema function and for diagnosing lymphedema.  It is minimally invasive and does not damage the visualized lymph vessels. This test is only prescribed by a physician to confirm a diagnosis.
 
All of the above will be discussed and demonstrated at LLN meetings in the Atlanta, GA, area. (see Calendar of Events on this website) 

Please contact LLN (Lighthouse Lymphedema Network)  

 
10240 Crescent Ridge Drive
 
Roswell, GA   30076
 
Phone 770-442-1317