Unless you or someone you know has gone through cancer treatment, the condition known as lymphedema is probably unknown to you. It happens in the course of radiation, chemotherapy or surgery. Lymph nodes are lost and it can have life-changing consequences.
Your lymphatic system keeps your body healthy. It circulates protein rich lymph fluid throughout your body, collecting bacteria, viruses and nasty waste products. Your lymphatic system carries this waste through your lymph vessels to the lymph nodes. Here, infection-fighting cells, called lymphocytes that live in your lymph nodes and flush it from your body, filter out wastes.
Lymphedema starts when your lymph vessels are unable to drain lymph fluid, typically from your body. This is called secondary lymphedema and is the most common form of lymphedema. The primary form, which is mostly a rare, inherited condition, comes from poor development of lymph vessels in your body.
The secondary form is mostly the result of surgical removal of lymph nodes or through damage caused by radiotherapy. Lymphedema can also be caused by tumors and infections of the lymph system.
Lymphedema can be very debilitating, causing swelling in parts or the whole leg or arm, including fingers and toes. Some people find it difficult to wear jewelry, watches or fit into clothes or shoes. Other symptoms of the affected area can include:
• Loss of range of motion or mobility
• Pain and discomfort
• Tingling sensations in the affected limb, much like pins and needles
• Recurring skin infections
• Blisters or wart-like growths on the skin
• Severe fatigue
Infections with this condition are of the most concern. The waste the body can't get rid of can cause potentially serious bacterial skin infections (cellulitis) that can spread rapidly. Even though cancer surgery has become more conservative in removing lymph nodes, often there is still a loss - but there is help and it does work.
I got into lymphedema therapy, because my mother suffered with it for decades. It's my goal to help patients maintain their lifestyle even after a loss of lymph nodes to cancer treatment, or other illnesses. At St. Mary's, we do this through a variety of assessments and education just before surgery. Post-operatively, we work on self-management "tools" for the patient.
Compression garments - These garments, properly fitted for troubled areas can control swelling and discomfort. Today there are many more comfortable options available than just a few years ago.
Self Manual Lymph Drainage - (Massage techniques) stimulating healthy lymph vessels and lymph nodes can assist in re-routing the lymph flow around blockages into nearby healthy lymph vessels and nodes. This is achieved with specific stretches and manipulations.
Skin Care - Even healthy people often ignore this. Your skin is the largest organ of your body and the first line of defense against bacteria and other pathogens. Dried, chaffed skin can provide an entry to germs and infections. Your skin needs hydration through moisturizers and water consumption.
Surgery - Newer options, including transplanted lymph nodes from the groin to the upper body are gaining acceptance, primarily for breast cancer patients, where nodes are removed. This will still require a therapy, as the body needs to be retrained in how to drain the waste.
I'm also treating older patients suffering from chronic venous insufficiency. Venous insufficiency is a condition in which the veins have problems sending blood from the legs back to the heart. This condition causing cramping and pain in the legs is also helped by lymphedema therapy.
Finally, my hope is for some legislative help in this struggle. Currently, Medicare, and other policies, do not cover medically necessary compression garments used daily in lymphedema treatment. As a result, many patients suffer from recurrent infections, progressive degradation and eventual disability because they can't afford the compression supplies required to maintain their condition. The Lymphedema Treatment Act before Congress would help these patients maintain their independence in their struggle against swelling.
Ashley Engle is a Lymphedema Therapist with St. Mary's Medical Center. She can be reached at 816-655-5700. For questions regarding inpatient occupational therapy please call 816-655-5661.