Lymphedema is a disorder that affects more than 100 million people worldwide. This condition is characterized by chronic swelling due to the accumulation of lymph fluid in the tissue. This is caused by absent, obstructed or dysfunctional lymphatics or lymph nodes. In normal function, lymph vessels filter large molecules of proteins, bacteria and other debris away from tissues for and then re-circulates them into the bloodstream. When the lymph system is blocked or damaged, this fluid accumulates and causes swelling. If left untreated, this swelling interferes with the delivery of oxygen to surrounding tissue, hinders wound healing, and can increase an individual’s risk of infection.

Once lymphedema is established, it cannot be cured but it may be managed with proper care and lifestyle changes. Treatment should begin as soon as lymphedema is diagnosed.

Causes of Lymphedema

Primary Lymphedema is caused by absent, underdeveloped, or dysfunctional lymphatics. This condition may be present at birth or may not be diagnosed until later in life, such as during puberty or adulthood. Research has suggested a genetic cause for this type of lymphedema.

Secondary Lymphedema, or acquired lymphedema is a caused by a blockage of the lymph system due to:

· Surgery, with removal of lymph nodes

· Radiation therapy

· Trauma

· Repeated infections

· Chronic venous insufficiency

· Paralysis of a limb

Lymphedema may develop in any part of the body. Common signs and symptoms include the following:

· Increase in size of limb or body part

· Feeling of heat in limb

· Pitting of skin, if pressed.

· Aching limb

· Puffiness

· Feeling of heaviness, tightness, stiffness, aching or fullness

· Limitation of movement

· Difficulty completing self-care tasks independently

· Red patches on the skin — this could indicate infection. Infection can cause or indicate onset of lymphedema.

Lymphedema can occur at any time after the initial "stressor" to the lymph system. Lymphedema techniques may also be used to treat edema due to illness or injury.

Prevention

You may be able to minimize your risk of developing lymphedema or decrease the severity of lymphedema by following simple interventions:

• Keep skin over all areas of the body clean and moisturized.
• Observe proper skin care after surgery or radiation.
• Avoid injury or infection of the extremities. For example: always wear shoes and socks, wear sunscreen daily to prevent burn, avoid exposure to extreme heat or cold.
• Observe precautions and begin proper exercise after mastectomy.
• Exercise, as directed by your physician or therapist.

• Nofify your physician as soon as you notice symptoms.

If you are diagnosed with lymphedema, you may receive any combination of the following interventions:

• Manual Lymphedema techniques: Light touch is used to redirect the lymph fluid. Self-massage is an essential part of the treatment.

• Compression bandaging/Compression garment: This low elastic or bandaging method promotes improved lymph flow by providing controlled pressure to the affected limb.

• Exercise: A specialized exercise program increases lymph flow, flexibility, mood and self-esteem. It can also decrease stress and empower the patient to take part in his or her treatment.

• Education: A specialized lymphedema therapist can help you understand lymphedema and how to manage it.

• Psychological and emotional support: The knowledge attained can help the patient deal with the physical and functional changes associated with lymphedema.

Treatment for lymphedema may be covered by your insurance company. Creighton University Medical Center will assess each individual’s reimbursement to identify any out-of-pocket costs that may arise.

Treatment may vary in duration depending on the severity of the Lymphedema.

For further information on lymphedema or to schedule an appointment with a certified lymphedema therapist, please contact the Department of Occupational Therapy at 449-4248