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For More Info Lymphedema

Initial Presentation
Causes of Primary Lymphedema
Causes of Secondary Lymphedema
Complications
Treatments & Drugs
Coping & Support

Lymphedema refers to swelling that occurs most often in your arms or legs. It may affect just one arm or leg, but sometimes lymphedema can involve both arms or both legs. The swelling occurs when a blockage in your lymphatic system prevents the lymph fluid in your arm or leg from draining adequately. As the fluid accumulates, the swelling continues. No cure for lymphedema exists. However, lymphedema can be controlled. Controlling lymphedema involves diligent care of the affected limb.

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Initial Presentation

Lymphedema is a type of abnormal swelling of an arm or leg. Swelling ranges from mild, hardly noticeable changes in the size of your limb to extreme swelling that can make it impossible to use the affected arm or leg.

Lymphedema symptoms include:

  • Swelling of part of the arm or the entire arm or leg, including the fingers, but frequently sparing the foot to a great extent
  • A feeling of heaviness or tightness in the arm or leg
  • Restricted range of motion in the arm or leg
  • Aching or discomfort in the arm or leg
  • Recurring infections in the affected limb
  • Hardening and thickening of the skin on the arm or leg

The lymphatic system circulates protein-rich lymph fluid throughout the body, collecting bacteria, viruses and waste products. The lymphatic system carries these subtances through the lymph vessels and drains into the lymph nodes. The wastes are then filtered by lymphocytes - infection-fighting cells - and ultimately eliminated from body.

Lymphedema occurs when the lymph vessels are unable to adequately drain lymph fluid from the arm or leg. Lymphedema can be either primary or secondary. This means it can occur on its own (primary lymphedema) or it can be caused by another disease or condition (secondary lymphedema).

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Causes of Primary Lymphedema

Primary lymphedema is a rare, inherited condition caused by problems with the development of lymph vessels in the body. Primary lymphedema occurs most frequently in women and usually affects the legs, rather than the arms. Specific causes of primary lymphedema include:

Milroy disease (congenital lymphedema)

This is an inherited disorder that begins in infancy and causes a malformation of the lymph nodes, leading to lymphedema.

Meige disease (lymphedema praecox)

This hereditary disorder causes lymphedema in childhood or around puberty. It causes the lymphatic vessels to form without the valves that keep lymph fluid from flowing backwards, making it difficult for the body to properly drain the lymph fluid from the extremities.

Late-onset lymphedema (lymphedema tarda)

This occurs rarely and usually begins after age 35.

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Causes of Secondary Lymphedema

Any condition or procedure that damages the lymph nodes or lymph vessels can cause lymphedema. Causes include:

Surgery

Can cause lymphedema to develop if the lymph nodes and lymph vessels are removed or severed. If the remaining lymph nodes and lymph vessels cannot compensate for those that have been removed, lymphedema may result in the arm.

Radiation Treatment for Cancer

Can cause scarring and inflammation of the lymph nodes or lymph vessels, restricting flow of the lymph.

Cancer

Cancer cells can cause lymphedema if they block lymphatic vessels. For instance, a tumor growing near a lymph node or lymph vessel could become large enough to obstruct the flow of the lymphatic fluid.

Infection

Can infiltrate the lymph vessels and lymph nodes, restricting the flow of lymph fluid and causing lymphedema. Parasites also can block lymph vessels. Infection-related lymphedema is most common in tropical and subtropical regions of the globe and is more likely to occur in undeveloped countries.

Injury

Injury that damages the lymph nodes or lymph vessels also can cause lymphedema.

In addition to history and physical exam, adjunctive information can be gained from venous duplex, MRI, CT scans, and lymphoscintgraphy.

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Complications

Lymphedema can lead to serious complications, such as:

Infections

Lymphedema makes the affected arm or leg particularly vulnerable to infections, including cellulitis and lymphangitis. Any injury to the arm or leg provides an entry point for an infection.

Elephantiasis

This condition occurs when the arm or leg becomes so hardened with thickened skin that range of motion is limited. Elephantiasis may make the skin on the arm or leg very weak, leading to chronic ulcers and repeated infections.

Lymphangiosarcoma

This rare form of soft tissue cancer can result from the most severe cases of untreated lymphedema. Lymphangiosarcoma originates in the lymph nodes and lymph vessels.

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Treatments & Drugs

Lymphedema cannot be cured. Treatment focuses on minimizing the swelling and controlling the pain. Lymphedema treatments include:

  • Exercises
  • Wrapping your arm or leg
  • Massage
  • Pneumatic Compression
  • Compression Garments

Compression garments are only helpful once the swelling has been reduced through the other therapies. However, they are the mainstay of long term treatment and the reduction in complications.

The management of lymphedema is perfomed in concert between a physician and a dedicated physical therapist. At Martha Jefferson Hospital we have a dedicated staff who treat all lymphedema conditions.

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Coping & Support

It can be frustrating to know that no cure exists for lymphedema. The management of this devastating disorder But if you find yourself getting down about the daily bandaging or constant need to protect your affected limb, know that you can control some aspects of lymphedema. To help you cope, try to:

Find out all you can about lymphedema.

Knowing what lymphedema is and what causes it helps you better understand the signs and symptoms you experience. The more you know, the better you can communicate with your doctor or physical therapist.

Take care of your affected limb.

Do your best to prevent complications in your arm or leg. Clean your skin daily, looking over every inch of your affected limb for signs of trouble, such as cracks and cuts. Apply lotion to prevent dry skin.

Take care of your whole body.

Eat a diet full of fruits and vegetables. Exercise daily, if you can. Reduce the stress in your life that you can control. Try to get enough sleep so that you wake up refreshed each morning. Taking care of your body gives you more energy, encourages healing and helps you control your lymphedema.

Get support from others with lymphedema.

Whether you attend support group meetings in your community or participate in online message boards and chat rooms, it helps to talk to people who understand what you're going through. Contact the National Lymphedema Network to find support groups in your area. They can also put you in touch with other people with lymphedema with whom you can connect via e-mail or letter.

If you feel frustrated or overwhelmed by lymphedema, talk to your doctor or other health care provider about how you feel. He or she should be able to address your concerns.

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