|What is lymphedema?Lymphedema is a swelling of a body part, most often an extremity, resulting from an accumulation of fluids, in such proportions to be palpable and visible. Lymphedema occurs when the lymph vascular system is not able to fulfill its function of reabsorption and transport of the protein and lymph load. Lymphedema occurs whenever lymphatic vessels are absent, underdeveloped or obstructed.
The condition often causes embarrassment and decreased mobility, discomfort and often repeated episodes of infection, cellulitis and lymphangitis. This can lead to depression and to general worsening of the patient’s life and health.
Fungal infections can be very frequent and these place a greater load on the lymphatic. Severe cases are associated with thickening of the skin, hardening of the limbs (fibrosis), leakage of lymph and massive swelling (elephantiasis).
What is the lymphatic system?Nutrients entering our bodies are transported by arteries and capillaries to tissue cells which are surrounded by interstitial fluid. The nutrients must pass through this fluid before reaching the cells. After metabolism, the cells dump waste products back into the fluid for removal by the venous blood capillaries and by a system of lymphatic vessels.
The lymphatic vessel system must drain the interstitial fluid of everything else. This includes the water (plasma) not resorbed by the venous reflow, plus unusable or waste matter such as proteins, bacteria, long chain fats, dusts (from coal and glass), dyes, dead cells and cell parts, mutant cells, etc.
These substances are considered to be Lymph Obligatory Load (LOL). Once the LOL enters the lymphatic system it is called lymph. Unlike the blood which circulates, lymph flows only one way. The lymph vessel system carries tissue fluids as well as metabolic waste from the tissue. Lymph is a clear, colorless fluid which originates in the tissue space.
Lymph is then transported through the lymphatic vessel system to lymph nodes where it is filtered and cleaned before returning to the blood circulatory system. Since the lymphatic vessel system has no pump (heart) of its own, movement of lymph is accomplished through a combination of forces, including good diaphragmatic breathing, arterial pulsation, skeletal muscle contractions, and peristaltic contractions.
If the lymphatic system fails or is impaired due to surgery, radiation, disease, or trauma, swelling can occur in the interstitial spaces increasing the distance between capillaries and cells. If proper drainage does not occur, cells are exposed to an undernourished, toxic environment. Disease can be the result. Therefore, it is crucial for the lymphatic system to function efficiently.
How does lymphedema occur?
A stagnation of protein develops in the tissue. This raises the colloid osmotic pressure and a protein-rich edema arises. There are more protein rich fluids in the tissue than can be transported and the proteins attract water by osmosis. The affected area becomes swollen and uncomfortable. This swelling decreases oxygenation of the tissues, interferes with their normal functions and makes them heal more slowly than normal. The excess protein also serves as a stimulus for chronic infection and can result in formation of excess fibrous tissue.
Lymphedema is a chronic, and if left untreated, progessive condition. It can, however, be brought under control by appropriate treatment and care. Lymphedema may be due to a primary (congenital) cause or a secondary cause including removal of the lymph nodes or trauma.
Factors that contribute to lymphedema include:
Impacts of lymphedema on an individual include:
- Combined surgery and radiation treatment.
- Combined surgery and post-operative infection.
- Infections such as insect bites and athlete’s foot.
- Sedentary life-style.
- Constrictive clothing or jewelry.
- Heavy breast prosthesis.
- Trauma to lymphatics (emotional, sunburn, surgery).
- Recurrent tumor.
Treatment of Lymphedema
- Swollen body part or limb.
- Heaviness and limitation of motion.
- Repeated episodes of infection.
- Skin thickening, lymph leakage through skin.
- Condition generally worsens over time.
- Multiple hospitalizations.
- General depression.
Lymphedema is a serious condition, indicating that the lymph system is unable to handle the lymph load. Treatment should begin as soon as lymphedema is diagnosed. The goal of treatment is to reduce the swelling and facilitate the flow of lymph fluid to the venous circulation of the affected area.The most effective approach used by therapists in many European countries is a method called COMBINED or COMPLEX DECONGESTIVE THERAPY; a four-step process, carried out over a four-week-period. The individual elements are as follows:
1. Massage Therapy – patients receive Vodder Manual Lymph Drainage once or twice a day to remove excess fluid and protein. MLD stimulates lymphangions to increase their activity, which results in a decompression and emptying of obstructed lymphatic channels.
2. Compression Therapy – Bandaging of the affected limb follows each MLD session. This is a precise procedure using specific bandages and interfacing materials.
3. Remedial Exercises and Breathing Techniques – further promote venous and lymphatic flow by activating the muscle and joint pumps.
4. Skin Care and Hygiene – Excellent skin cleansing with antibacterial washes and neutral balanced pH lotions help to eliminate bacterial and fungal growth.
5. Compression Garments – After optimal reduction of the limb is reached, the therapist measures and fits the client with a quality compression garment to maintain the reduction of the swelling.