March is Lymphedema Awareness Month. Lymphedema is a condition that causes an accumulation of fluid in different areas of the body including the arms, legs, trunk, abdomen, head and neck.
Susan Selby, a certified lymphedema therapist at Meritus Total Rehab Care, said that up to 10 million Americans are affected by lymphedema and lymphatic diseases.
“The swelling consists of a protein-rich fluid which gets progressively worse if left untreated,” Selby said. “The lymphatic system assists with absorbing the protein and returning it to the bloodstream, but swelling develops if it is not working properly.”
There are two types of lymphedema: primary and secondary. Primary lymphedema occurs when there is an abnormality in the lymphatic vessels that can be present from birth or hereditary. Secondary lymphedema occurs when there is an insult to the lymphatic system such as surgery, removal of lymph nodes, radiation, infection, tumors or vein problems.
According to Selby, in the early stages of lymphedema, the swelling comes and goes and the tissue is soft, but over time, the swelling becomes more constant and the tissue gets harder.
“If it becomes more severe, you may notice fluid leaking from the affected area or you may develop cellulitis which is an infection that requires medical attention,” she said.
Most of the time, lymphedema is diagnosed as it becomes visible, but some physicians send patients for lymphoscintigraphy to determine if there are issues within the lymphatic system before it can be seen. Dye is injected between the fingers or toes and a special camera follows it as it moves through the lymphatic vessels to determine if there are problem areas.
Lymphedema is not usually painful, but it might become painful as it worsens or if infection is present.
“Unfortunately lymphedema is typically a lifelong issue, so it is important to seek treatment as soon as possible to get the swelling under control and to learn how to manage it,” Selby said.
Lymphedema can be a disfiguring condition, especially if left untreated, and can have a psychological as well as a physical impact on people’s lives. It can limit someone’s ability to perform daily activities, self-hygiene and walking.
Selby said patients often have difficulty finding clothes and shoes to fit over their swollen arms and legs. Lymphedema in the head and neck can affect a person’s ability to swallow and even to breathe. People with lymphedema can also develop many different skin issues related to the swelling.
“Treatment should be provided by a certified lymphedema therapist who has specific training,” Selby said. “Treatment typically consists of manual lymphatic drainage, which is similar to a light massage, skin care and compression bandaging.
Girth measurements are taken regularly to chart progress. Once patients reach a plateau, they are fitted with a compression garment. There are many types of garments, but the most common types are compression stockings, sleeves and gloves or Velcro compression wraps. A compression pump is also beneficial to assist with self-management once treatment is completed.
Selby said that if you have been experiencing problems with swelling, you should talk to your doctor to potentially get a referral for therapy.
Meritus Total Rehab Care has certified lymphedema therapists on staff who are available with a referral. For more information, call 301-714-4025 or visit MeritusHealth.com.