As defined by the Mayo Clinic: Lymphedema refers to swelling that generally occurs in one of your arms or legs. Secondary Lymphedema tends to affect just one arm or leg due to damage to the lymph nodes or vessels, but can also affect the entire quadrant in which the lymph dumps, including the torso and groin regions. Primary Lymphedema affects the entire body and can be seen bilaterally in arms, legs and neck as well as abdomen and groin areas. Primary Lymphedema is a deficiency in the function of the lymphatic system at birth, but may not show up until adulthood.
Lymphedema is caused by a blockage in your lymphatic system, an important part of your immune and circulatory systems. This blockage is caused by damaging the lymph nodes with surgery, radiation or injury. In addition to this blockage, the working nodes are not capable of taking on the additional inflammation and toxins and therefore back up and become hardened and inefficient. They basically can not handle the capacity created by the blockage. The blockage prevents lymph fluid from draining well, and as the fluid builds up, the swelling continues. Proteins are not removed efficiently and once they are accumulated and deposited in the tissues, it causes permanent change of the tissue (thickening).
There’s no cure for lymphedema, but it can be controlled. Controlling lymphedema involves diligent care of your affected limb.
Lymphedema symptoms include:
- Swelling of part of your arm or leg or your entire arm or leg, including your fingers or toes, torso or groin
- A feeling of heaviness or tightness in your arm or leg
- Restricted range of motion in your arm or leg
- Aching or discomfort in your arm or leg
- Recurring infections in your affected limb
- Hardening and thickening of the skin on your arm or leg
The swelling caused by lymphedema ranges from mild, hardly noticeable changes in the size of your arm or leg to extreme swelling that can make it impossible to use the affected limb.
Causes of secondary lymphedema
Any condition or procedure that damages your lymph nodes or lymph vessels can cause lymphedema. Causes include:
- Surgery can cause lymphedema to develop if your lymph nodes and lymph vessels are removed or cut. For instance, surgery for breast cancer may include the removal of one or more lymph nodes in your armpit to look for evidence that cancer has spread. If your remaining lymph nodes and lymph vessels can’t compensate for those that have been removed, lymphedema may result in your arm.
- Radiation treatment for cancer can cause scarring and inflammation of your lymph nodes or lymph vessels, restricting flow of lymph fluid.
- Cancer cells can cause lymphedema if they block lymphatic vessels. For instance, a tumor growing near a lymph node or lymph vessel could become large enough to obstruct the flow of the lymph fluid.
- Infection can invade your lymph vessels and lymph nodes, restricting the flow of lymph fluid and causing lymphedema. Parasites also can block lymph vessels. Infection-related lymphedema is most common in tropical and subtropical regions of the globe and is more likely to occur in developing countries.
There’s no cure for lymphedema. Treatment focuses on reducing the swelling and controlling the pain. Lymphedema treatments include:
- Exercises. Light exercises that require you to move your affected arm or leg may encourage movement of the lymph fluid out of your limb. They should focus on gentle contraction of the muscles in your arm or leg.
- Wrapping your arm or leg. Bandages wrapped around your entire limb encourage lymph fluid to flow back out of your affected limb and toward the trunk of your body. Use gradient pressure on the entire limb.
- Massage. Lymph Drainage: A special massage technique called manual lymph drainage may encourage the flow of lymph fluid out of your arm or leg. Manual lymph drainage involves special hand strokes on your affected limb to gently move lymph fluid to healthy lymph nodes, where it can drain.
- Pneumatic compression. If you receive pneumatic compression, you’ll wear a sleeve over your affected arm or leg. The sleeve is connected to a pump that intermittently inflates the sleeve, putting pressure on your limb. The inflated sleeve gently moves lymph fluid away from your fingers or toes, reducing the swelling in your arm or leg.
- Compression garments. Compression garments include long sleeves or stockings made to compress your arm or leg to encourage the flow of the lymph fluid out of your affected limb. Once you’ve reduced swelling in your arm or leg through other measures, your doctor may suggest you wear compression garments to prevent your limb from swelling in the future. Obtain a correct fit for your compression garment by getting professional help — ask your doctor where you can buy compression garments in your community. Some people will require custom-made compression garments.
When several of these treatments are combined, this therapy may be referred to as complete decongestant therapy (CDT). CDT generally isn’t recommended for people who have high blood pressure, diabetes, paralysis, heart failure, blood clots or acute infections.
If you’re at risk of developing secondary lymphedema, you can take measures to help prevent it. If you’ve had or are going to have cancer surgery, ask your doctor whether your particular procedure will involve your lymph nodes or lymph vessels. Ask if your radiation treatment will be aimed at any of your lymph nodes, so you’ll be aware of the possible risks.
To reduce your risk of lymphedema, try to:
- Protect your arm or leg. Avoid any injury to your affected limb. Cuts, scrapes and burns can all invite infection, because these things will overload the lymphatic system and may result in lymphedema. Protect yourself from sharp objects. For example, shave with an electric razor, wear gloves when you garden or cook, and use a thimble when you sew. If possible, avoid medical procedures, such as blood draws and vaccinations, in your affected limb.
- Rest your arm or leg while recovering. After cancer treatment, avoid heavy activity with that limb. Early exercise and stretching are encouraged, but avoid strenuous activity until you’ve recovered from surgery or radiation.
- Avoid heat on your arm or leg. Don’t apply heat, such as with a heating pad, to your affected limb.
- Elevate your arm or leg. When you get a chance, elevate your affected limb above the level of your heart, if possible.
- Avoid tight clothing. Avoid anything that could constrict your arm or leg, such as tight-fitting clothing and, in the case of your arm, blood pressure readings. Ask that your blood pressure be taken in your other arm.
- Keep your arm or leg clean. Make skin care and nail care high priorities. Inspect the skin on your arm or leg every day, keeping watch for changes or breaks in your skin that could lead to infection. Don’t go barefoot outdoors.
- Lymph Drainage Therapy: Manual therapy to direct the Lymph to drain to healthy nodes in necessary to control the onset of lymphedema. A trained therapist manually moves the lymph and drains the limb to keep down swelling and prevent overloading the lymphatics of the affected area.
Coping and support
It can be frustrating to know that no cure exists for lymphedema. But if you’re frustrated with the daily bandaging or constant need to protect your affected limb, know that you can control some aspects of lymphedema. To help you cope, try to:
- Find out all you can about lymphedema. Knowing what lymphedema is and what causes it helps you better understand the signs and symptoms you experience. The more you know, the better you can communicate with your doctor or physical therapist.
- Take care of your affected limb. Do your best to prevent complications in your arm or leg. Clean your skin daily, looking over every inch of your affected limb for signs of trouble, such as cracks and cuts. Apply lotion to prevent dry skin.
- Take care of your whole body. Eat a diet full of fruits and vegetables. Exercise daily, if you can. Reduce the stress in your life that you can control. Try to get enough sleep so that you wake up refreshed each morning. Taking care of your body gives you more energy, encourages healing and helps you control your lymphedema.
- Get support from others with lymphedema. Whether you attend support group meetings in your community or participate in online message boards and chat rooms, it helps to talk to people who understand what you’re going through. Contact the National Lymphedema Network to find support groups in your area. They can also put you in touch with other people with lymphedema with whom you can connect via email or letter.www.lighthouselymphedema.org