What is Lymphedema?

  • Lymphedema is an accumulation of lymphatic fluid causing abnormal swelling of the arms, legs, breast, abdomen, neck or head.
  • Lymphedema develops when lymphatic vessels are damaged, lymph nodes are removed (secondary), or when lymphatic vessels are impaired and/or missing (primary).
  • Lymphedema occurs when the impairment becomes so great that the lymphatic fluid exceeds the lymphatic transport capacity.
  • Lymphedema becomes apparent when the protein rich fluid builds up and swelling begins.

Stages of Lymphedema

Stage 1 (mild)
Upon waking in the morning the limb or affected area is almost a normal size.The tissue is still in a "pitting stage" ( when pressed by a finger the area indents and holds the indentation).
Stage 2 (moderate)
The tissue is "non-pitting" (when pressed by a finger the tissue bounces back without leaving an indentation). The tissue has a spongy consistency.
Stage 3 (severe)
The tissue at this stage is hard (fibrotic) and will be unresponsive to the touch. The swelling is irreversible and the limb is very large and swollen. Infections are possible at any stage of lymphedema but occurrence becomes greater as stages progress. A swollen limb, left untreated, becomes hard (fibrotic) and full of lymph fluid which is high in protein and a perfect medium for bacteria and infections.

Causes of Lymphedema

Primary

  • Present at birth for unknown causes or associated with arterial-venous abnormalities.
  • Lymphedema Praecox - appears during puberty, mostly in girls, and usually affects one lower extremity.
  • Lymphedema Tarda - occurs in both male and female adults. The onset is sudden with no apparent cause and can affect one or both extremities.

Secondary

  • Surgical procedures and/or radiation therapy in the treatment of Breast, Gynecological, Head , Neck, Prostate or Testicular, Bladder, Colon Cancers or Melanomas.( Due to treatment, there is removal of, or damage to the lymph nodes or vessels so that lymph fluid is no longer able to be transported properly in the body).
  • Trauma - injuries and accidents in which the lymphatic system is interrupted or damaged
  • Infections - which interrupts normal lymphatic pathway function

Treatment Options

Synergistic Approach (SA)

United Medical believes in a therapeutic approach to Lymphedema treatment that must be integrated and multi-faceted in it's nature. The combined actions of various forms of treatment can work in a synergistic fashion towards the re-balancing of the microcirculation and of the tissues affected by Lymphedema. Working together manual lymphatic drainage (MLD), pneumatic sequential compression pumps with garments, and stand alone garments can help alleviate lymphedema patient's symptoms.

United Medical's basic belief is that Lymphedema relief is obtained through reduction maintenance

The products designed for reduction maintenence are:

  • Mechanical Pumps from Bio Compression and Huntleigh
  • Night - Time Garments which are non-elastic
  • Day - Time Garments such as Circ Aid, Med Assist, Reid Sleeve
  • Stockings such as Juzo Stockings & Jobst Stocking

Manual Lymphatic Drainage (MLD) Information

This treatment is a gentle light touch massage. This prevents damage to the tissues. It promotes lymph flow through the collateral (superficial) lymph vessels to channel the lymph into the abdominal area ( the "watershed") and into normal functioning lymphatic vessels and nodes. These collateral lymph vessels are usually working normally and the problem lies in the deeper vessels which were damaged and scarred.

Bandaging Information

A therapist places compression bandaging around the limb. Often foam chip pads are placed under the bandaging to increase pressure on fibrotic area to break down scar tissue. These bandages stay on 24 hours a day throughout the treatment period. They come off only to shower, do skin care, assess the swelling reduction and to do the MLD.

Skin Care Information

Use a soap with a low pH., unscented and not antibacterial soaps. A good liquid soap is Cetaphil. The skin must be moisturized after bathing. Use a lotion like Eucerin or Nivea. If there are any irritations use an antibacterial cream. Always dry the area very well,and gently, after washing.

Exercise Information

An exercise program will beoffered to each patient. The program will improve muscular contractions and joint mobility.There will also be strengthening exercises for the limb that will reduce muscle atrophy. Muscular contractions along with the low-stretch bandages provide constant counter pressure to keep the lymph fluid moving.

Reduction & Maintenance = Nutrition + Exercise + MLD + Products