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Lymphedema Treatment

The Lymphedema Treatment Center of Sansum Clinic offers the treatment of choice for Lymphedema: Complete Decongestive Treatment by a certified therapist utilizing Manual Lymph Drainage (MLD). The goals of the Lymphedema Therapist are to reduce the edema of the affected extremity, improve any accompanying disability to independent functional levels and to teach patients how to manage their condition.

Symptoms & Diagnosis

It is estimated that 2.5 Million Americans suffer from some form of lymphedema. Some symptoms of lymphedema will disappear while others remain or new ones develop. Symptoms include:
  • Tightness and heaviness in the affected limb(s)
  • Skin tightness or changes in texture (such as thickening, dryness or multiple bumps)
  • Recurring infections
  • Decreased flexibility in the arm or leg
  • Difficulty fitting into clothing
  • Tight fitting jewelry (such as a ring, wristwatch or bracelet)

In most cases, clinical diagnosis of lymphedema is made by measurements and observation of the symptoms.

Treatment and Therapy

As long-term condition, lymphedema cannot be cured but it can be managed successfully with appropriate treatment. Untreated lymphedema can progress to the lymphostatic elephantitis stage and puts patients at high risk for skin infections such as cellulitis.

At Sansum Clinic's Lymphedema Treatment Center we utilize the most widely accepted form of treatment: Complex Decongestive Therapy (CDT). The program includes:

Manual Lymph Drainage (MLD): This is a special lymphatic decompressive technique applied once a day for 30 minutes utilizing specific manual movement pattern following the lymphatic pathways which will empty and decompress obstructed lymph vessels. MLD facilitates the unhindered flow of lymph fluid into the venous circulation allowing the limb to return to normal or near normal size.

Compression: Compressive bandages and/or garments are applied to the affected limb following each MLD session and are worn overnight until the next MLD session. This compensates for the diminished tissue pressure in lymphedema and prevents the affected limb from refilling with evacuated lymph. The bandages used are not "ace" bandages, which can cause tourniquets. The bandages are "low stretch" bandages that achieve its elastic quality as a result of the weave pattern instead of the addition of rubber. This weave pattern bandage maintains a constant compression that does not contract or expand with muscle contraction. At the end of the course of treatment, when the limb is normal or close to normal size, an elastic support garment is fitted for each patient.

Hygiene and Skin Care: Meticulous hygiene and nail care is essential in minimizing the opportunity for the development of localized or general infection.

Remedial Exercises and Elevation: Every patient is instructed and encouraged to participate in some form of active exercise with the bandages in place. This therapy activates each muscle group and joint of the swollen limb and results in an increased lymph flow, and with time, the dilation of the lymph vessels.

Home Program and Follow-Up: Each patient is discharged with a custom designed Manual Lymph Drainage (MLD) and compression program to maintain results achieved in therapy.

Precautions for Lymphedema Patients

Avoid extreme temperature changes: Increased skin temperature will cause an increased blood supply to the area of the body, which causes an increased lymphatic load. It is best to avoid hot tubs, steam baths, saunas, hot dishwater and sunburns.

Avoid Infection: if a cut or insect bite occurs in a lymphatic extremity, wash the limb with soap and water, apply antibiotics and an adhesive bandage. Any opening in the skin will allow bacteria to enter the body. Since lymphedema is an abnormal accumulation of protein rich fluid, this is an excellent culture medium for the rapid reproduction of bacteria that can lead to a progressive local infection and potentially a systemic infection. It is recommended that an electric razor be used for shaving.

Avoid tight and constrictive clothing and jewelry: Tight garments and jewelry will compress delicate lymphatic pathways, causing a "tourniquet effect," further preventing re-absorption of lymph fluid from the affected extremity.

Avoid repetitive extreme resistive activity of the affected extremity:
Activities such as weight training, repetitive lifting and placing of objects are to be avoided without the compensation of a compression garment. These activities cause increased blood flow to the extremity, which causes an increase in the lymphatic load.

Avoid blood pressure checks, blood drawing or injections in the affected extremity: Blood pressure cuffs can constrict delicate lymphatic pathways. Injections or blood draws will create an opening in the skin, which can provide an opening for bacteria to enter.

Prevent and Minimize Lymphedema

  • Maintain a healthy diet consisting of plenty of fruits and vegetables, low salt and fat, and high fiber foods.
  • Maintain a reasonable weight.
  • Avoid excessive alcohol.
  • Avoid long periods of sitting or standing, or dependent limb positions (leaving the limb hanging).
  • No deep tissue massages to affected area, as this will increase blood flow to affected area, which will increase the lymphatic load.
  • When traveling by air, patients with lymphedema must wear a compression garment.
  • Do remedial exercises on a regular basis and maintain an active lifestyle.
  • After decongestive therapy treatments, wear your compression garment.
  • Schedule 4-to 6- month follow-up appointments with your therapist for garment fitting and upgrades.
  • Continue regular health check-ups.
  • Treat infections vigorously. If you suspect that you have an infection, but are not sure, make an appointment with your physician and let her/him decide.
  • Seek treatment for even the slightest lymphedema.

Health Education

Individuals undergoing lymphedema therapy and their caretakers may benefit from our Free Health Education Class called "Strength After Breast Cancer - A Physical Therapy Program."(click here to learn more or register online for this class)