The lymphatic system is a system which is just as important as arteries and veins of your body. The blood carries nutrients and oxygen to your cells and carries the wastes away, the lymphatic system removes all fluid and other substances such as proteins which leak out of the blood system and into the tissues. Any swelling you get, either a small or large area, is a sign that the lymphatic system is not working properly. When this happens protein and fluid accumulate. If the lymphatic system does not work, there are many other cells that also cannot function optimally, the most important of these are macrophages. The macrophages are special cells that live in the tissues.
What Is Lymphoedema?
Lymphoedema is swelling of a limb or the body due to excessive fluid in the tissues of the body. Fluid is normally drained from the tissues by minute vessels called lymphatics. The fluid (colourless) which flows in the lymphatics is filtered through lymph nodes (glands) in the armpits, groin and abdomen.
Lymphoedema can be caused by damage to the lymphatics due to injury, burns, infection, radiation, and surgery associated with breast or other cancers, This is classified as secondary Lymphoedema (blocked or cut lymphatic vessels). Some people are born with an inadequate drainage due to a deficiency of lymph vessels or there are many, but they are very dilated and do not pump properly. The latter is classified as primary Lymphoedema (lack of lymphatic function).
Lymphoedema can cause discomfort due to an increased size and weight of the body/limb(s). Joint movements may become restricted and the patient may not be able to wear normal clothes. This may cause problems of a psychosocial nature.
How Rapidly Does Lymphoedema Occur?
Once the lymphatics are damaged, Lymphoedema may occur at any time. Sometimes it starts immediately and lasts for life; sometimes it occurs for a few weeks, goes away and may or may not return; sometimes it appears years after the even. Once the lymphatics are damaged a very trivial thing may set it off, eg, an insect bite, bee sting, sunburn, carrying heavy weights, a long aircraft flight or even immobility.
Apart from that which occurs briefly after the blockage and goes away, once Lymphoedema starts it most often get worse. This worsening is usually slow in primary lymphoedemas and rapid in secondary ones. If inflammation occurs (eg, an infection), then it becomes worse very quickly.
Can Lymphoedema Be Treated?
Yes, Lymphoedema, can be treated but in most cases, cannot be completely cured. However it can be controlled and the swelling decreased by a conservative program of skin care, massage, compression garments, compressive bandaging, a mild exercise regime, laser therapy, hydrotherapy, and relaxation techniques.
Many therapists have now been trained to treat Lymphoedema in this country. Contact your local Support Group who will be able to refer you to a suitable therapist or the Lymphoedema Association of Australia.
The earlier Lymphoedema is diagnosed and treated, the more successful the results.
In most cases, diuretics do not help with Lymphoedema, except of course in some cases where they made be needed for some other disease, eg, heart failure.
Skin Care And Limb Care
Persistent oedema (swelling) will make the limb more prone to infection. If the latter occurs see your doctor immediately for treatment. No injections or blood pressure readings should be attempted in the affected limb or that side of the body at any time.
The limb may become thickened and harder. Skin lesions may occur. Scrupulous hygiene and avoidance of burns and abrasions is essential. Use a good quality moisturiser.
Massage Therapy
The physiotherapist/masseur/masseuse will perform a gentle massage to empty lymph vessels on areas remote from your swelling. These areas will become the reservoir into which the fluid from the affected part will be emptied. You can be taught to self massage.
Bandaging
The most important part of the early of the early treatment. It will squeeze oedema from the affected limb.
Compression Garments
Made to measure or “off the shelf” garments, will maintain reduction of oedema.
Some Do’s And Don’ts For Lymphoedema Patients
* Do wear loose fitting clothes
* Do involve yourself in mild exercise
* Do take care of your diet and thus your weight, attempt low fat, low salt, high fibre, high fluid intake diet, but try to take caffeine and alcohol only in moderation.
* If your limb(s)/body appears red or warn or becomes swollen or more swollen, IMMEDIATE steps for treatment are needed, contact your doctor for regimen of antibiotics.
* Do elevate you limb(s) as this helps drainage.
* Avoid strenuous exercise, sports which cause physical pain.
* Avoid long periods of inactivity.
* Avoid heat and the sun.
* Avoid any event which could disrupt the continuity of the skin e.g. cuts, scratches, pinpricks, picking at hangnails/cuticles, sunburn, etc.
* Do not carry a purse, shopping bag or wear constrictive jewellery on the swollen limb.
Signs To Be Aware Of For Onset Of Lymphoedema
* A feeling of heat in the limb
* A bursting sensation of the limb
* Redness (red patches may indicate an infection - see your doctor immediately. This may also cause/indicate the onset of Lymphoedema)
* Puffiness
* Pitting of the skin when pressed with the thumb
* An aching limb/shoulder particular the back of the shoulder area in the afternoon.
* Any swelling, or heat in the trunk on the same side as the operation
* A swelling on the opposite side (eg, after a mastectomy the other breast or chest wall starts to increase in size)
* A swelling of any other limb/(s), or a general all-over swelling which is not due to overeating or any drugs you may be taking.
Signs to be aware of for worsening of Lymphoedema
* Any of the previous signs for its onset
* A compression garment becoming too tight
* Pins and needles in the fingers or toes
* Lack of feeling in any areas of a limb
* Leaking ares (fistulae) starting to occur
(The information in this handout is based on information in the Lymphoedema Support Group of SA’s flyer, Lymphoedema Assessment Clinic, Flinders Medical Centre Hospital booklet and the Lymphoedema Association of Australia papers).
*Source:
The Lymphoedema Support Group SA Inc
PO Box 1006
Kent Town SA 5071
Ph: (08) 8204 4711
Email: neil.piller@flinders.edu.au
Email: jnoble@senet.com.au
