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Lymphedema
Lymphedema: its cause and how to manage it
The lymphatic system is a transport system accompanying and closely associated with the blood circulation system in our body. It is a semi-circulatory system beginning with it capillaries directly in the organs where they can absorb tissue fluid and proteins before removing them. This colourless protein-containing tissue fluid is known as lymph. The lymph is transport by the capillaries to the conducting vessels of the lymphatic system. These vessels are empty into the veins, connecting the lymphatic system with the blood vessel system. The flow of lymph fluid is caused by the rhythmic pulsation of the lymph vessels walls.
Both the veins and the lymph vessels have the job of removing waste substances. Large molecules such as proteins are removed by the lymph. The lymph capillaries have large pores to “pull” in the substances dissolved in the water. The excess absorbed water is filtered out of the lymphatic system nodes, which thus have an important regulating function. Therefore damage to the lymphatic system will mean that proteins and tissue fluid remain where they are in the tissues – between the cells. The resulting swelling of tissues caused by the accumulation of lymph tissue is known as lymphedema.
There are basically 2 types of lymphedema – primary lymphedema, usually caused by lymph vessels malformations present from birth and secondary lymphedema, usually caused by surgical removal of lymph nodes. We will focus on secondary lymphedema in this article.
Secondary Lymphedema
Any injuries to the healthy lymphatic system can potentially result in permanent damage leading to secondary lymphedema. Most cancer cells migrate through the lymph vessels to the nearest lymph nodes where they form metastases. Therefore, it is important to surgically remove some of the lymph nodes in the affected area. The removed lymph nodes are then examined for cancer cells, indicating whether surgery has to be followed up by chemotherapy of radiation therapy. Radiation therapy can also damage the lymph vessels.
When the lymph drainage is interrupted, the body finds ways of compensating for this damage to certain extend. The degree of impairment will always remain due to the fact that lymph nodes cannot be regenerated. Depending on how well this compensatory mechanism works and the degree of stress to which the particular person’s lymph system is subjected, it may be that no lymphedema occurs at all. If lymphedema do develops, it is usually soon after the operation or even after a delay of several years. There are different stages of lymphedema. It is therefore wise to approach the doctor treating you to re-examine you if swelling or inflammation occurs over the affected areas.
Management of Lymphedema
If the edema (swelling) is in the beginning stage, the affected area can be indented by applying pressure. You can reduce the edema by raising the affected limb and the swelling will reduces on its own.
Other forms of management include complex decongestive physiotherapy, which is best performed by a trained physiotherapist. Its management includes manual lymph drainage, compression therapy and exercises.
For self management, sometimes medical compression garment may works. Depending on the differing degrees of lymphedema, compression garments come in varies styles and compression class and may be bought over-the-counter or need to be custom-made. Compression therapy works by increasing the direction flow of lymph from an area of higher pressure to the area of lower pressure. In lymphedema, the lymph vessels are no longer working properly, therefore the idea behind compression therapy is to assist the tissue by applying pressure from the outside, which allows the fluid to flow back into the lymph vessels and veins.
Some Useful Tips to Remember:
Diet – Ensure that you are not overweight as obesity places an additional burden on the lymphatic system.
Clothing – Avoid restrictive items such as narrow bra straps and tight undergarment.
Your responsibility – No blood pressure measurement, blood sample taken, injection, acupuncture and so on should be carried out on the affected limb.
Protection and Precaution – Protect you skin from over exposure to the sun as the warmth will cause widening of the vessels. Be cautious of any insect bites or strings as the inflammations may worsen the lymphedema. If gardening is requires, wear proactive gloves. Avoid overstraining from carrying heavy objects or sports involving extreme stress which may have an adverse effect on the lymphedema.
[You may be pleased to know that Can-Care now carry medical compression garment which may be bought over-the-counter. You need to come personally to get your measurement done to ensure that the garment is correctly prescribed for you. For further enquires, you may contact us for an un-obligated consultation.]
