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What is Lymphedema?

Lymphedema is the swelling of a body part caused by an accumulation of lymphatic fluid. Lymph nodes in the body, are specialized structures that help to clean the lymph fluid of bacteria and viruses. Without lymph nodes, lymph fluid builds up and stays under teh skin causing the limb to swell. This problem commonly occurs when:

  • Lymph nodes fail to develop normally
  • There is damage to the lymph nodes due to trauma, surgery or illness
  • There is a removal or destruction of the lymph nodes due to cancer or related treatments

Within each person there are over 500 - 1000 lymph nodes located throughout the body. These places include: trachea, neck, armpits, chest cavity, lungs, abdominal cavity, intestines, and the pelvis/groin.

Who is at Risk for Developing Lymphedema?

People who have had many of the following procedures may be at risk for developing lymphedema:

  • Simple mastectomy in combination with axillary (arm pit) lymph node removal.
  • Modified radical mastectomy in combination with axillary (arm pit) lymph node removal.
  • Combined cancer surgery and radiation therapy to a lymph node region (such as neck, armpit, groin, pelvis or abdomen).
  • Radiation therapy to a lymph node region.

Lymphedema can occur within a few days, months, or years after surgery. A small amount of swelling is normal for the first four to six weeks after surgery.

Prevention of Lymphedema

Lymphedema can be prevented or controlled (if it develops) by following the recommendations below:

  • Maintain good nutrition.
  • Reduce foods high in salt and fat.
  • Exercise regularly.
  • Avoid infections.
  • Stay alert for signs of infection.
  • Avoid tight clothing, shows or jewelry.
  • Avoid heavy lifting with the affected arm (even a purse or bag).
  • Keep your skin meticulously clean.
  • Take precautions during visits to your doctor.
  • Inform your doctor of any symptoms.

Signs and Symptoms

If you suspect any of the symptoms listed below, call your healthcare provider right away. Prompt treatment can help get the condition under control.

  • Swelling in the arms, hands, fingers, shoulders, chest, or legs. The swelling may occur for the first time after a traumatic event (such as bruises, cuts, sunburn, or sports injuries), after an infection in the part of the body that was treated for cancer, or after an extended (more than three hours) airplane trip (due to changes in pressures).
  • A "full" or heavy sensation in the arms or legs.
  • Skin tightness.
  • Decreased flexibility in the hand, wrist, or ankle.
  • Difficulty fitting into clothing in one specific area.
  • Tight-fitting bracelet.

You CAN be treated. . .

The highly skilled rehabilitation team at Avera McKennan Outpatient Therapy Services can help treat your lymphedema as well as teach you self care techniques for maintenance and reduction of lymph fluid. Treatment involves the following:

  • Manual Lymph Drainage (MLD) - gentle manual lymph drainage improves the activity of intact lymph vessels by mild mechanical stretches on the walls of the vessels. MLD also redirects the flow of lymph to pooling in the legs.
  • Compression Therapy - compression therapy applies significant compression to the affected area in order to prevent reaccumulation of fluid. Short-stretch bandages and compression garments are used to help reduce fluid in the effected extremity.
  • Decongestive Exercises - exercises that aid the lymphokinetic effects of the joint and muscle pumps to get fluid out of the effected extremity. Individual programs vary depending on the extent of lymphedema.
  • Education on Skin and Nail Care - patients become education on the use of low pH lotions used to keep the skin moist as well as various skin and nail care methods.

Other methods of treatment may be used in conjunction with all or some of the above treatments.

Learn more about the Avera McKennan Outpatient Lymphedema Clinic »

What Can I do if I Already Have Lymphedema?

  • Avoid extreme temperature changes. Do not use hot tubs, whirlpools, sauna or steam baths. Use warm, rather than very hot, water when bathing or washing dishes. Always wear sun protection when going outdoors.
  • When traveling by air, ask your healthcare provider if you should wear a compression sleeve on your affected arm or a stocking on your affected leg.
  • When sitting or sleeping, elevate your affected arm or leg on pillows. Avoid prolonged lying on your affected side.
  • Your healthcare provider may refer you to a physical therapist or occupational therapist that specializes in managing lymphedema. The therapist will assess your condition and develop an individual treatment plan to manage your lymphedema.
  • Therapy may include specific exercises or a complete exercise program, limitation of certain activities that are vigorous or repetitive, and recommendations for a compression sleeve, bandages, manual lymph drainage and possibly a pump.
  • Continue to see your healthcare provider for frequent follow-up visits as recommended.

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