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Lymphedema

Lymphedema is an accumulation of lymphatic fluid in the tissues, which causes swelling.  It may occur in any area of the body but is usually seen in the arms or legs.  There may be a full sensation in the limb or limbs, the skin may feel tight, there may be decreased flexibility in the joints, jewelry and clothing may become tight in specific areas.  It should not be confused with edema resulting from venous insufficiency. Untreated edema can progress into a combined venous/lymphatic disorder that is treated with the same methods used for lymphedema.

Lymphedema becomes apparent when the protein-rich lymph fluid builds up in the interstitial tissue and swelling begins.  It occurs when impairment to the flow becomes so great that the fluid exceeds the lymphatic system transport capacity.

Primary lymphedema occurs when lymphatic vessels are missing or impaired.  It may affect up to four limbs, as well as other parts of the body. It may be present at birth due to arterial venous abnormalities or due to unknown causes.  Lymphedema Praecox appears in girls during puberty and usually only affects one leg.  Lymphedema Tarda occurs in both genders during adulthood.  There is a sudden onset with no apparent cause and may affect one or both extremities.

Secondary lymphedema develops when lymphatic vessels are damaged or lymph nodes are removed. Accidents, infections, radiation or surgery may injure the vessels or create scar tissue that causes fascial restrictions or narrowing in the vessels.

Lymphedema occurs in three stages from mild to severe.  Stage one is spontaneous and reversible.  The tissue indents when pressed with the fingers and holds the indentation.  This is referred to as the "pitting" stage.  Stage two also is spontaneous but irreversible.  The tissue has become spongy and when pressed will not hold an indentation.  Fibrosis marks the beginning of the hardening of the limbs and increased limb size.  The third stage is lymphostatic elephantiasis.  The swelling is irreversible and the limb or limbs are very large in size.  The tissue is hard and unresponsive.  Patients may have reconstructive surgery at this point to reduce the size of the limbs. When the limbs reach this stage, they may use function, suffer skin breakdown, chronic infections, and irreversible complications.  If left untreated, the most severe cases may develop into a rare form of lymphatic cancer called Lymphangiosarcoma, which occurs most often with secondary lymphedema.

Surgery of any kind (including reconstructive surgery) in any area of the body may cause secondary lymphedema to begin immediately or months or years later, depending upon scar tissue formation.  It may also develop if chemotherapy is administered on the same side as surgery or after repeated aspirations of a seroma (a packet of fluid that occurs post-operatively) in the axilla or around a breast or groin incision.

Aircraft flight may also trigger lymphedema in post surgical patients.  Compression garments prevent lymphedema due to flying, whether or not you have lymphedema.

Tomoxifen is a drug that can cause blood clots and deep venous thrombosis.  It may also cause lymphedema in the lower extremities.

Radiation treatment used for a variety of cancers may damage healthy lymph nodes and vessels, causing adhesions, which may trigger the onset of lymphedema due to the interruption of the normal lymph flow.  It is important to monitor the site of radiation for skin changes such as increased temperature, discoloration (erythema) or blistering, which may lead to lymphedema.

Secondary lymphedema may develop after lymphangitis (an infection), which interrupts the normal lymphatic flow.  Lymphangitis may include rash, red blotchy skin, itching, discoloration, increase of swelling and/or skin temperature, heavy sensation in the limb, pain and a sudden onset of high fever and treatment.

When infection is present, all other lymphedema treatments must be stopped.  It is especially important to cease the manual therapies used at Windsong Therapy and Wellness, in order to prevent spread of the infection to other areas of the body.  The infection must be treated with antibiotics and cleared up completely before manual therapy may be resumed.

Some forms of cancer may also limit the types of manual therapy that are used.  Again, it is very important that the cancer not be spread throughout the body.  Windsong Therapy and Wellness will work out a treatment plan with the patient's doctor in order to bring the patient the most relief with the least risk.

An experienced therapist, such as those at Windsong Therapy and Wellness, must treat patients, who suffer from congestive heart failure, in order to prevent more fluid being introduced into the body than the heart can handle.

Windsong Therapy and Wellness begins by balancing the body.  This helps everything from lymph to energy to flow better.  We then use very specialized hands on techniques to remove fascial restrictions and restore lymph flow. Manual lymphatic drainage is a gentle light touch massage that prevents damage to the tissues while promoting lymph flow through the superficial lymph vessels.  It channels the lymph in to the abdominal area and into normal functioning lymph nodes and vessels so it may be removed from the body.  Restoration of the flow will reduce swelling and any pain or discomfort the patient is feeling.  It is our goal to restore function, relieve pain, and improve every patient's quality of life.

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This website last updated on 31 July 2010

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All information available through this Web site is intended for general knowledge only and is not a substitute for medical advice, assessment or treatment of any of the conditions discussed. You should always consult with your medical practitioner or specialist regarding medical care and seek their opinion in relation to your medical condition. Individuals involved in the operation of this site are not responsible for your use of this information or for any information provided in linked sites, articles or pages.  References and copies of source material are available upon request.

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