What Is Lymphedema? What Is the Best Treatment? (video/podcast)
Treatment options include physical therapy and surgery
Treatment options include physical therapy and surgery
The lymphatic system is a network of tissues and organs that produces, stores and carries a clear fluid called lymph through your body. It is part of your immune system. In addition to helping fight infection, the lymphatic system supports healthy fluid levels in your body and helps absorb nutrients.
If the lymphatic system is damaged or blocked, it can lead to swelling in your body caused by fluid building up in the soft tissue. This is called lymphedema.
In this video, San Diego Health host Susan Taylor talks about lymphedema with Manish Champaneria, MD, a plastic surgeon who specializes in lymphedema surgery at Scripps Clinic, and Maryam Rahnema, a physical therapist and certified lymphedema therapist at Scripps.
Lymphedema symptoms and diagnosis
The lymphatic system can become damaged or blocked due to several reasons, including genetics, diseases, trauma or surgery. In some cancer surgeries, for example, surgeons remove lymph nodes, which are lumps of tissue that help filter the lymphatic system.
The most common symptom of lymphedema is swelling of the affected body part, usually an arm or leg. In some cases, the swelling can start relatively quickly after the damage to the lymphatic system. Typically, though, lymphedema does take some time to develop, from weeks to months or even years in certain patients.
Without treatment, the swelling can get worse. “If you don’t get a handle on this, the limb can exponentially grow,” says Dr. Champanera. “Over time, you can get fatty deposits on that limb too. And that’s a high risk for infection.”
A physical examination is the first step in diagnosing lymphedema and may be all that is needed. An imaging exam such as an MRI also may be useful.
Lymphedema treatment
Physical therapy is the first step in treatment for lymphedema. In addition to helping to keep the swelling down, it may help prevent infection.
“Physical therapy for lymphedema is multifaceted. We call it congestive therapy, which consists of lymphatic drainage with a very light form of massage,” says Rahnema. “Basically, we’re stretching the skin and enhancing the movement of the lymphatics.”
Lymphedema therapists also may use a vasopneumatic device, which is a type of pump, to remove excess fluid, as well as a compression sleeve to help control swelling. Exercise is also an important part of treatment to get the body moving, which gets the excess fluid moving and draining.
“We work with patients until we get the limb as optimally small as possible. Then we teach them what to do and they carry on at home,” says Rahnema. “They wear their compression sleeve, they have a machine, and they can continue their own lymphatic drainage.”
If lymphedema is severe and doesn’t respond to physical therapy, several types of surgery may help. One surgery involves transferring lymph nodes from one part of the body to the affected limb to better process the fluid. Another option is bypass surgery, which connects lymphatic channels to small veins to bypass the damaged lymphatic system.
“The goal of lymphatic surgery and physical therapy is to reduce the size of the limb, to reduce the infection rate, and to improve quality of life,” says Dr. Champanera. “It can take several months to years to see the effects, so patience is a virtue when it comes to lymphedema surgery.”
He adds that it is important to take very good care of your skin and keep it clean, dry and moisturized. Use care with the affected limb and avoid having vaccinations or IVs inserted into it.
When to see a doctor
If you have swelling that seems unusual or doesn’t improve, Dr. Champanera recommends contacting your doctor right away.
“You should see your primary care physician as soon as you notice swelling that might be associated with a recent surgery, with a recent infection or if swelling came out of the blue to the legs,“ he says. “It’s important to see a doctor quickly and get treated quickly. “
Listen to the podcast on causes and treatments for lymphedema
Listen to the podcast on causes and treatments for lymphedema
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