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What is Lymphedema?
"The Chronic Unknown Disease" can affect any man, woman, or child in any part
of the body, children being most severely affected. When lymph nodes or lymph
vessels are damaged, destroyed, or missing resulting in an accumulation of wastes
and fluids in an affected body part, swelling occurs. This is LYMPHEDEMA.
Lymphedema now affects about 2% of our population and this figure is increasing.
Lymphedema is a condition that results in the breakdown of the body's ability to
remove and filter intercellular fluids. The result is an excessive accumulation of
lymph, the fluid that originates in the spaces between body cells. Lymph normally
flows into a successively larger series of vessels deeper in the body and is
eventually emptied into the venous system. Hundreds of lymph nodes stationed
throughout the body filter out proteins, micro-organisms, body cell wastes, and
other waste particles too large for the veins to transport.
Most people know very little about lymphedema, how and why it occurs or what
can be done about it. This not only includes people affected with lymphedema but
also those healthcare professionals who come in contact with them. Patients in the
USA who develop lymphedema do so most frequently as a result of prior cancer
treatment for breast cancer, melanoma, cervical cancer, removal of lymph nodes, or
radiation for tumors. This is secondary lymphedema. The most extreme form of
secondary lymphedema is elephantiasis. Elephantiasis is characterized by
tremendous swelling, the overlying skin is very dark in color, thick and course -
resembling an elephant's hide. Elephantiasis can develop after long periods of
untreated lymphedema. Still other cases of lymphedema develop as a result of
burns, trauma from surgery, accidents, cuts or breaks in the skin or even insect
bites. There are also large numbers of people born with this condition - this is
Very little in the way of therapy has been available to relieve both the physical and
emotional distress brought on by this condition. One of the problems of
lymphedema is that is does not remain stationary - it continually progresses.
Untreated lymphedema can result in grossly swollen body parts containing areas of
stagnated lymph leading to fibrosis (hardening of the tissues and loss of skin
elasticity). Because this lymph fluid is protein-rich, it is a perfect medium for
growth of bacteria, and the area/limb becomes highly susceptible to infection and
cellulitis. Any break in the skin can open the way for bacteria to enter.
Furthermore, severe swelling and fibrosis leads to immobility due to increased
swelling in the joints; chronic infections because of stagnation of wastes in the
tissues of the affected part, and irreversible complications.
Untreated lymphedema can result in grossly swollen body parts, immobility,
chronic infections, and a cancer known as lymphangiosarcoma. And since
lymphedema is a chronic disease, it requires proper treatment and maintenance to
control swelling, prevent complications, and increase quality of life.
Those most severely affected are children with primary lymphedema. Most of these
children have an accompanying congenital disease known as Klippel-Trenaunay,
which not only affects body tissues, but also blood vessels and bones. The resulting
effects are port wine stains with severe varicose veins, swollen bulbous tissues,
especially of the feet and toes, and unequal bone growth of the legs. Treatment
includes not only combined decongestive therapy and other usual methods but also
custom gradient compression garments, and specially made shoes. Since each
lymphedema case is different, these children, as well as all lymphedema patients,
will have lymphedema the rest of their lives, will always have special needs and
must be treated individually, or case specific.
Signs and Symptoms of Lymphedema
When lymphedema begins to develop, the signs to watch out for are:
1. Prickly, burning, or itchy sensations in a suspected area.
2. A heavy or achy feeling; skin feeling tight and full.
3. A ring, watch, or bracelet becoming too tight.
4. A tight sensation in a hand or foot.
5. Clothes not fitting in a certain area.
6. Increased swelling in an area that sometimes recedes at night but returns, as the
body is vertical for a long period of time.
7. Persistent swelling & skin that pits with finger pressure
8. Decreased flexibility, especially in the knee, elbow, ankle, or wrist
Stages of Lymphedema:
Latent Stage: a lymphatic or lymphovenous problem exists but there are no visible
signs or symptoms.
Stage 1: (MILD), "pitting" edema, when tissue is pressed there is a finger
impression in the skin that stays. Usually in the morning upon rising the affected
area is about normal size and the edema has receded.
Stage 2: (MODERATE), "non-pitting" edema, tissue is spongy; the tissue bounces
back when pressed without indentation
Stage 3: (SEVERE), swelling is irreversible and the limb or area becomes very
large. The tissue is hard (fibrotic).
Treatment for lymphedema includes: Combined Decongestive Therapy (CDT),
gradient compression garments, circumferential measurements of affected body
part, intense skin care, a nutritional and fluid intake regimen, specific exercises
with compression, water therapy, supportive shoes, manual lymph drainage,
gradient sequential pneumatic pumping device, gradient bandaging, directional
flow garment, keeping active and a positive enhancing life support.
If lymphedema is left untreated, the limb or area will continue to swell with areas
of stagnated lymph that isn't moving. This stagnation leads to fibrosis (an
accumulation of stagnated lymph that doesn't move and becomes hardened).
Because this fluid is protein-rich, it is a perfect medium for growth of bacteria.
Furthermore, severe swelling and fibrosis leads to loss of mobility, other chronic
infections and sometimes irreversible complications.
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Title: What is Lymphedema
Author: Carmen Dunn
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