About Lymphedema

Perhaps it began with a swelling of the foot or leg that you didn’t even notice. Or perhaps you underwent cancer surgery and noticed tissue swelling on the arm or leg after the operation – now it’s clear that this is lymphedema. According to figures from the World Health Organization, up to 240 million men and women worldwide are affected by a lymphatic disease.

How does lymphedema arise?
When the lymphatic system can no longer move fluid through the body, a backlog of lymph builds up in the tissue.  Lymphedema will usually arise at the extremities, ie arms and legs. However, it can also occur throughout the body. Lymphedema is divided into two categories: primary and secondary.
Primary Lymphedema: Usually caused by congenital abnormalities relating to lymph system. Injuries or severe hormonal fluctuations (puberty, pregnancy) are often triggers. In 60% of cases, edema arises at both extremities at different times.
Secondary Lymphedema:  Operations in which the lymph nodes are removed or disturbed are the usual cause. These operations include surgery for  breast, ovarian, testicular, or prostate cancer. Irradiation, injuries, inflammation, or infections can also lead to secondary lymphedema. The edema always occurs at a body part in which the drainage is impaired.

Early Diagnosis and Treatment
The development of lymphedema can be divided into four stages.
Stage 0: Latency Stage
The lymphatic system is not working properly but can manage the amount of lymph by means of compensatory mechanisms. There is no visible or perceptible edema.
Stage I:  Spontaneously Reversible Stage
The tissue is soft and can be slightly depressed to form a visible dent. The lymphedema forms in the night and goes back down when the leg or arm is elevated.
Stage II: Spontaneously Irreversible Stage
The tissue hardens and it is difficult or impossible to depress the tissue to form a dent. Pain and restricted movement can occur.
Stage III: So-Called Elephantiasis Stage
Severe increase in the circumference of edema, sometimes reaching extreme dimensions.

Complex (Physical) Decongestive Therapy – CDT
A therapeutic principle has become established for the treatment of lymphedemas, which is recommended as the only promising treatment model for patients with lymphatic disorders.
Manual Lymph Drainage: MLD is a gentle stroking massage that is only performed by specially trained therapists. As the lymphatic vessels are stroked, the congestion is dispersed and the lymphatic channels become free again.
Lymph Therapy Machines: In conjunction with (or instead of) MLD treatment, using a lymph therapy machine will disperse the congestion of lymph and free the lymphatic channels.
Compression Therapy: This prevents lymph from flowing back after lymphatic drainage. The maintenance therapy with compression stockings is an absolute must.
Skin Care: The treatment of the affected skin areas with oily creams prevents the skin from drying out. Since this area of skin is more sensitive and prone to infection, good skin care should always be maintained.
Movement in Compression: Special exercise for the affected body area stimulates lymphatic drainage and assists the compressive effect. It is important to wear compression stockings (or sleeves) at all times. Create your individual exercise plan with your MLD therapist.

Be your own “Lymphedema Manager”
Although lymphedema is a chronic condition, there is a great deal you can do to ensure that the edema does not get any worse.
Visiting the Physician: Ensure that no examinations – blood tests, blood pressure measurements, injections, acupuncture – are performed on the affected arm or leg.
Diet: A healthy plant-based diet (mostly fruit, vegetables, and whole grains – little meat and fat) promotes your well-being. Avoid ready-made meals as these are usually high in fat. Make sure you eat low-salt food as salt binds water in the body unnecessarily. Make sure you drink enough water throughout the day; this “rinses out” the body!
Rest: Daily elevation of the affected area helps to prevent painful congestion and relieves pressure.
Circumference Measurement: Regular circumference measurements at the same point on the affected arm or leg allow you to detect a change to the edema immediately and deal with it right away.
Heat: Heat is dangerous to your edema as it cam promote lymph flow. Do not expose yourself to intense heat, for example: in direct sunlight, hot compresses, visits to the sauna, hot baths or showers.
Injuries: Take precautions to avoid injuries during gardening, housework, or sport. Even the smallest wounds – including insect stings, bites or scratches – can lead to inflammation. Disinfect small wounds immediately.
Compression Garments: Wear your compression garments – stockings or sleeves – every day. This will not only assist in the flow of lymph, but will also reduce increased swelling and pain. Wearing garments each day will keep your edema to a minimum.

Medical Compression Garments – Your Daily Companion
Wearing compression garments is an important element of CDT. Garments reinforce the therapeutic success that has already been achieved in the decongestion phase (through MLD or a therapy machine). Wearing compression garments at all times during the management phase demonstrably improves the lymph flow in the affected tissue and thus stops the edema from progressing further. Containing the lymphedema significantly improves the quality of life.