What is lymphedema?
Impairment of the lymph transport system of the body, which causes the accumulation (stagnation) of protein rich fluid in the interstitium, protein draws fluid into the interstitial spaces, this results in the tissue swelling.
There are two kinds of edema primary and secondary.
Primary edema, basically is a condition a person is born with. It may manifest at birth and anytime therafter up on till the age of about 34 (an inherited condition).
Secondary edema is usually acquired after the removal of lymph nodes for biopsy or cancer treatment and also by irradiation during cancer treatment, there are several other factors that may precipitate lymphedema.
Who is affected by Lymphedema?
At high risk are persons who undergo axillary lymph node dissection. There is no specific risk factors associated with developing the condition, however an estimated 12% – 35 % of women develop lymphedema after these procedures.
We have acquired a segmental bioimpedance analyzer. This equipment is able to detect early signs of lymphedema in the limbs. And for those recieving treatment allows us to chart your progress.
How does a Decongestive Therapist help with the management of lymphedema?
A decongestive therapist helps with the management of lymphedema by:
- Manually moving the lymph and directing its flow to lymph nodes that are functioning. Extensive knowledge of the body’s lymph layout enables the therapist to do this.
- The therapist then applies short or long stretch bandages to the limb, which the patient wears at all times except when taking a wash.
- The therapist also teaches the patient exercises depending on clients ability. Movement to encourage circulation is of utmost importance.
- Referal to a nutrtionist may be made.
- At the end of every week the patient is measured, this is done so that progress can be graphed.
- At the end of a period of three or four weeks the patient limb size is measured again, this time for custom compression dressing,
It should be noted that there is no cure for Lymphoedema; the goal is to prevent it in patients who are at high risk of developing it, and for those who already have it to maintain function, prevent spread, and keep the swelling down.
What precautions can be observed?
The affected body part, usually a limb should be protected from trauma, cuts, insect bites, injections, blood pressure must never be taken on the affected limb. The limb should be examined every day for hardening (fibrosis) – indication of tissue change. Changes in the size of the limb especially after exercise. Elevate the limb if this occurs.
Can it be prevented?
The cause of Lymphoedema is unknown, it is therefore difficult to prevent. What we do know is that there are certain people more susceptible to developing the condition. It is therefore important that people in the high risk group ( mastectomy and lumpectomy patients) monitor any changes in limb size and consult your physician or a certified decongestive therapist who can assess your situation and provide advice on what your options are.
Are there lymphedema support groups?
- Lymphovenous Association of Ontario www.lymphovenous-canada.ca
- Lymphedema Association of Ontario firstname.lastname@example.org
- Alberta Lymphedema Association (ALA) www.albertalymphedema.com
- Lymphology Association of North America (LANA) www.clt-lana.org
- NAVALT – North American Vodder Association of Lymphatic Therapy www.navalt.org
What are compression garments, how do they help?
Compresson garments are specialised stockings, (garments) that provide gradient compression. On the leg or arm compression garments deliver pressure from the highest amount of pressure in the ankle or wrist area to the least amount of pressure where the garment (stocking) terminates. Compression garments are the standard of care in the management of lymphoedema, chronic venous insufficiency, varicosities (varicose veins). Compression garments and the muscle pump increase the tissue pressure by helping to push fluid back into the capillaries and preventing venous and lymph backflow.
Custom compression garments are also available for abdominal and head oedema.
Our therapists are Vodder certified therapists, The Dr Vodder School is a worldwide trainer of lymphedema therapists. Dr Emil Vodder is the originator of manual lymphatic drainage. Our therapist train to use the original Dr Vodder method and they are required to recertify every three years to maintain standards.
Will insurance cover lymphedema treatment and compression garments in Ontario?
You would have to check with your insurance provider for this.
In Ontario there is an ADP ( assistive device provider ) service.