What is lymphedema?

Lymphedema refers to tissue swelling caused by an accumulation of protein-rich fluid that's usually drained through the body's lymphatic system. It most commonly affects the arms or legs, but can also occur in the chest wall or breast, abdomen, head & neck, as well as genitals. Understanding Lymphedema is essential to help control it. How it develops is either genetics (primary) or from injury (secondary). There are stages 0-3 and is considered progressive. If treated early enough, you can possibly avert the negative outcomes of soft tissue changes and progressions leading to serious infections as cellulitis or erysipelas.

How is lymphedema treated?

The gold standard and least invasive way of treating Lymphatic disease is Complete Decongestive Therapy, otherwise known as CDT. This treatment is comprised of four main components in two phases. First phase is the Intensive phase done by the therapist. Second phase is Maintenance phase done independently by the individual. Both phases include MLD, Skin Care, Compression and Exercise. Manual Lymphatic Drainage (MLD) is performed with various hand positions as described by Dr. Vodder. The reason MLD is so effective is due to its ability to absorb and transport lymphatic fluid that carries molecular wastes. When this transport is disrupted the result becomes swelling (edema). With long term edema a cascade of inflammatory events can occur. Fibrosis (a hardening of the soft tissue), infections become more likely, changes to the skin texture with development of conditions such as papillomas, hyperkeratosis, and fungi.

Skin care is a must to reduce the risk of bacterial and fungal growth which will reduce the risk of infections and provide protection to the skin’s continuity. Skin is considered the first line of defense against infections. Patients will be instructed in skin and nail care, use of appropriate PH lotions or creams to decrease the bacteria on the surface of the skin.

Compression bandaging is an intricate part of the control. Without it all fluid returns post MLD due to body weight in combination with gravity. Bandaging is done with a particular type of short stretch bandage and is very effective method of not only keeping the first achieved reduction, but continues to reduce the volume of girth. It is also effective with breaking down the indurated (hardened) tissue and improves the muscle and joint pump with activity.

Gentle exercises are done to activate the fluid return. It is important to wear compression while doing these exercises. Initially, the sessions will be low level and will slowly increase the duration based on the responses from the patient. Exercises should never be overdone. Working through pain, soreness, shortness of breath or fatigue is discouraged. Instructions will be provided for risk reduction practices.

These tools are the gold standard of care for lymphatic disorders.

What is lipedema?

Lipedema is a chronic medical condition characterized by a symmetric buildup of adipose tissue (fat) in the legs and arms. A common but under recognized disorder, lipedema may cause pain, swelling, and easy bruising. It may be accompanied by an unusual texture within the fat that can feel like rice, peas, or walnuts beneath the surface of the skin. The intensity of pain may range from none to severe, and its frequency may be constant, come and go, or only occur when the fat is pushed on. Limited public awareness of lipedema, coupled with few research-backed treatments, can lead to exacerbation of symptoms as well as physical and emotional distress. Common symptoms include fatigue, muscle pain, or easy bruising. Treatments follow the lymphedema protocol.

Why should oncology patients have wellness care?

According to the Mayo Clinic “The evidence keeps rolling in: Exercise can be one of your most important cancer treatments. For anyone dealing with a cancer diagnosis, that’s great news.” Benefits are plentiful, especially with greater numbers of survivorship. Improving complaints of pain, addressing changes of cardiovascular, pulmonary and neurologic changes due to the cancer itself, treatments and emotional toll. Too much time being sedentary worsens the outcomes for patients, with an already state of de-conditioned systems.

Safety is paramount, especially for those who are immunocompromised through chemotherapy. The risk when exposed to infectious pathogens can be devastating. Plus, having the opportunity to exercise in their own environment creates more functional outcomes. Training is adapted to activities of daily living. For instance, the exercises like “sit to stand” supports the client getting in and out of their chair or off the toilet. Another example would be for strengthening the upper extremity “push/pull” for maintaining their home environment.

Manual techniques are used to address the side effects that cause stress, nausea, fatigue, post-surgical pain, depression, anxiety and improving all around quality of life issues.

Specific exercises are developed for addressing the de-conditioning effects of inactivity. The goal of returning back to the lifestyle and the level of pre-cancer life is possible. Closely monitoring vital signs to work within the appropriate level of activities. Survivorship is greater than it’s ever been and the quality of life issues are important to reclaim.

What can massage do?

Years of research support massage therapy for many health treatments. In fact, consumers are turning to massage to support their health needs now more than ever before.

A recent consumer study sponsored by AMTA indicates that 88 percent of individuals view massage therapy as beneficial to overall health and wellness. From relieving pain, without use of opioids, to managing cancer symptoms and reducing depression, explore the many health advantages of massage therapy.

Do you only work with the lymphedema or oncology population?

I work with a variety of people, not only for lymphedema or oncology. The purpose of IPW is to provide a service that will improve the quality of life for those living with pain and restrictions. If you would like to have a consultation, I would be honored to assist you with your goals.