The Union Recorder


May 6, 2014

ORMC: Understanding primary and secondary lymphedema

MILLEDGEVILLE — Our bodies have a network of lymph vessels and lymph nodes. This network collects fluid and debris that are in the body’s tissue, outside the bloodstream. Lymph vessels are a lot like the veins that carry blood through the body, but instead of carrying blood, these vessels carry clear, watery fluid called lymph.

When the lymph vessels are damaged, lymph nodes are removed or when lymph vessels are impaired or missing, the lymph system may not be able to handle the amount of fluid it needs to transport. This fluid backs up, accumulating into the tissues, and is called lymphedema.

There are two types of lymphedema: primary and secondary. Primary lymphedema has no known cause and may be present from birth. Secondary lymphedema is much more common and results from another condition or problem, such as cancer, infection or trauma. One of the most common causes of secondary lymphedema is surgery and radiation therapy for breast cancer.

The stages of lymphedema are:

Stage I (Mild) - Upon waking in the morning, the swollen arm or leg is almost a normal size, and as the day progresses the swelling gets worse. The tissue is still in a “pitting” stage (when pressed by a finger the area indents and holds the indentation.)

Stage II (Moderate) - The tissue is “non-pitting” (when pressed by a finger the tissue bounces back without leaving an indentation). The tissue has a spongy consistency.

Stage III (Severe) - The tissue at this stage is hard (fibrotic) and does not indent at all when pressed. The limb is very large and swollen. If left untreated, the swollen limb is at a high risk for becoming infected.

Treatment for lymphedema can take several forms:

Manual lymph drainage is used to promote lymphatic flow through healthy lymph vessels to channel the fluid around the damaged or impaired vessels and nodes. The fluid then continues its “normal” flow and empties back into the blood circulatory system.

Bandaging - The swollen limb may be wrapped with layers of compression bandages. These bandages help move or pump the extra fluid out of the swollen arm or leg.

Exercise - A regular exercise program, under the direction of a physical or occupational therapist, is very important. Gentle range of motion, strengthening exercises and aerobic exercise, such as swimming and walking, are vital to successful treatment of lymphedema.

The Rehab Services Department at Oconee Regional Medical Center is here to help patients with lymphedema. Marlena Waddell, a registered and licensed Occupational Therapist and a certified lymphedema therapist, is available to help manage lymphedema through manual lymph drainage, bandaging instruction, skin care education, garment fitting and exercise instruction. Please call 478-454-3640 for more information.


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