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Special 3 part blog series

Part 3 – What is the treatment for Lymphoedema?

Blog by Alyaa Mokh’ee (Lymphoedema Physiotherapist)

 

In this last part of the blog series, we will explore the treatment options offered by a certified therapists to manage your Lymphoedema.

The specific management of your Lymphoedema treatment will vary according to your goals, level of motivation for self-management, and the extent of your condition.  Working alongside your Lymphedema therapist, you will collaborate to establish a personalised management plan which you will be required to integrate into your daily routine to optimise the on-going relief of your symptoms.

During the early stages of Lymphoedema, management is largely focused on education, exercises and elevation to assist with the self-management of your Lymphoedema. A compression garment/sleeve may also be prescribed for air travel and for exercises if deemed appropriate.

Education topics covered (not exhaustive):

  • Lymphatic system and how they function
  • Risk factors impacting lymphoedema
  • Adopting a healthy lifestyle and encouraging exercises as tolerated
  • Skin care to limit the exacerbation of lymphoedema

 

COMPLEX LYMPHOEDEMA THERAPY

Patients with lymphoedema that has progressed will likely require Complex Lymphoedema Therapy (CLT) to assist with lymphoedema management. This is usually done in 2 stages; the treatment phase before progressing to the self-management/maintenance phase. The primary aim of the treatment phase is to reduce as much of the swelling as possible. This phase can take up to a few days to a couple of weeks depending on the severity of the lymphoedema.

TREATMENT PHASE

Education

All patients will be offered an education session surrounding the lymphatic system and how it functions. The education session will also emphasise on the importance of healthy weight management and regular exercise.

Skin Care

Good skin care is paramount to the prevention of skin infections as they could aggravate your lymphoedema. Good skin involves ensuring that the skin is adequately moisturised and that you practise appropriate sun care in the warmer months. It is also recommended to regularly check for any skin breaks and/or monitor for any fungal infections that could increase your risk of infections.

Manual Lymphatic Drainage (MLD)

Manual lymphatic drainage is a specific massage that only a trained lymphoedema therapist can provide. It involves the strategic application of light pressure to stimulate specific lymph nodes to encourage lymph flow. Each MLD session will be tailored to the area and stage of swelling.

Self-Lymphatic Drainage (SLD)

Self-Lymphatic Drainage is usually a simplified version of the MLD, given to you to complete at home. It is recommended that you complete SLD to get the most benefit in between sessions with your lymphoedema therapist.

Compression Bandaging

Compression therapy via bandages is aimed at reducing the extent of swelling. It assists with improving lymphatic flow out of the affected area. Whilst compression is helpful to assist with the management/reduction of swelling, if implemented by an un-trained person, could lead to increased swelling in other areas of the body. Your lymphoedema therapist will discuss with you what is appropriate in your Complex Lymphoedema Therapy regime.

SELF-MANAGEMENT/MAINTENANCE PHASE

Once the swelling has reduced and is stable with minimal fluctuations, you will enter the self-management/maintenance phase. As the self-management/maintenance phase is lifelong, adherence is essential to ensure that the swelling does not return.

Education, skin care and SLD is encouraged in the maintenance phase as a tool for self-management.

Other options offered during the maintenance phase include:

Compression Garments

Compression garments may be prescribed to you to ensure maintenance of swelling reduction. Your lymphoedema

therapist will discuss with you what type and style of garment will suit your condition.

Wraps

Wraps can be prescribed as an alternative in instances where patients might not be able to tolerate or put on a compression garment. They aim to provide the same level of compression that compression garments do.

 

EMERGING TREATMENT OPTIONS

Pneumatic Pumps

This device provides pressure to the affected limb via a compression pump which mimics the principles of MLD and is usually used as an adjunct to SLD or MLD. It can be hired for home treatment or used in clinic (if available).

Low level Laser Therapy

At present time, there is some research suggesting that low level laser therapy could reduce any thickening of tissue, therefore improving lymphatic flow. This is usually used alongside lymphatic drainage and compression therapy. As it is an emerging therapy, with more research to be done, this option may not be available in all clinics.

While these treatments are offered by your lymphoedema therapist, there may be other surgical options that your doctor might suggest. In these cases, it is always best to consult with the appropriate specialist in order to determine what the best options is for your situation.

 

Back to Lymphoedema

PART 1 – What is Lymphoedema?

PART 2 – How is Lymphoedema diagnosed?

 

Book an appointment today for your assessment!

Blog by Alyaa Mokh’ee (Lymphoedema Physiotherapist)

Special 3 part blog series

Part 2 – How is Lymphoedema diagnosed?

Blog by Alyaa Mokh’ee (Lymphoedema Physiotherapist)

 

In Part 1 we learnt about our lymphatic system and how it works. In Part 2, we will be exploring how Lymphoedema gets diagnosed.

Confirmation of  Diagnosis

It may be suspected by family, friends, yourself or your medical practitioner as a potential diagnosis. It could also be discussed when you go for routine Specialists’ appointments after or during cancer treatment.

Most doctors and specialists will refer you to a certified Lymphoedema Therapist for a thorough assessment and confirmation of the diagnosis.

A majority of sufferers will have had significant swelling prior to seeing a therapist, although, there is a significant number of cases where swelling may not be as obvious but other symptoms may be present.

Lymphoedema Therapists will:

  • Explore your swelling history and changes in its presentation over the course of time.
  • Request specific tests from your medical practitioner to exclude other causes of swelling; for example Cellulitis or Deep Vein Thrombosis (DVT)
  • Complete a Bioimpedance Measure (if available) to calculate how much fluid is present in affected versus un-affected limbs
  • Undergo a Volume Assessment to construct a baseline and to monitor fluid changes over time
  • A Full Body Assessment which includes establishing the location of swelling, skin changes and potential limitations present. Photos may be taken to track progress and stability of your condition.

In some cases, your Specialist or Medical Practitioner might arrange for you to have further imaging procedures to examine the capacity and functionality of your lymphatic system.

With this comprehensive assessment model, your certified Therapist will be able to determine if it is actual Lymphoedema or a condition that only presents like the condition.

 

Before we go on to how it would be managed, it is also important to note that there are 2 types of Lymphoedema – Primary and Secondary Lymphoedema.

Primary Lymphoedema is caused by a congenital defect in the development of lymphatic vessels and is usually present from a young age. This could include an abnormal number of lymphatic vessels with impaired function.

Secondary Lymphoedema is caused by any potential damage to your lymphatic system.

Your lymphatic system can potentially be damaged by:

  • Radiation / Radiotherapy and associated scarring
  • Removal of lymph nodes
  • Surgery around sites of lymph nodes and/or major lymph vessels, and associated scarring
  • Side effects from cancer treatment
  • Cancer itself (invasion into lymph nodes or encroaching onto lymph vessels)
  • Recurrent infections like Cellulitis
  • Trauma/ Extensive injury
  • Lack of movement

 

 

Back to Lymphoedema

PART 1 – What is Lymphoedema?

PART 3 –What is the treatment for Lymphoedema?

 

Book an appointment today for your assessment!

Blog by Alyaa Mokh’ee (Lymphoedema Physiotherapist)

Special 3 part blog series

Part 1 – What is Lymphoedema

Blog by Alyaa Mokh’ee (Lymphoedema Physiotherapist)

 

I have excessive swelling in my legs/arms, I must have lymphoedema!

There are many popular misconceptions that prolonged extensive swelling is always lymphoedema. It is also widely believed that once you have it, that there is nothing you can do to manage the condition.

Luckily, this is simply not true! Read on to find out more!

Oedema vs Lymphoedema

Oedema is defined as the excessive collection of fluid in your tissues or cells.

Lymphoedema, on the other hand, is a condition where there is a build-up of excessive amounts of protein-rich fluid (lymph) in your tissues, resulting in swelling of one or more region(s) of your body.

They look the same! How do I tell the difference?!

Lymphoedema can often present as other health conditions, including:

  • Congestive Heart Failure
  • Malnutrition
  • Liver and Kidney Disorders
  • Deep Vein Thrombosis
  • Venous Insufficiencies

However, the defining features of lymphoedema are:

  • Tightness or heaviness in a limb
  • Increased and/or visible swelling in the limb
  • An aching feeling
  • Pitting/indentation of skin with pressure of affected limb

Whilst not conclusive, these features are indicative of a malfunction in your lymphatic system.

Where is my lymphatic system in the body and what does it do?

Your lymphatic system is embedded throughout different layers of your body.

They Include:

  • Lymph vessels – valves ensure one-way movement
  • Lymph nodes – in your neck, underarm, groin and deep in abdomen
  • Lymph fluid

 

Your lymphatic system works alongside your circulatory system. Unlike the circulatory system which loops and circulates around the body, the lymphatic system is a one-way system.

This normal process starts with lymph fluid being accumulated within your tissues. The lymph contains toxins, bacteria, waste products and proteins that have escaped from your circulatory system.  Lymph fluid then gets transported to your lymph nodes via your lymph vessels. These nodes then filter the lymph fluid and returns any proteins and vitamins back into your circulatory system. Excess water and waste products are then transported to your liver and kidneys to be eliminated from your body.

Lymphoedema happens when there is a fault/interruption in this process.

 

Back to Lymphoedema

PART 2 – How is Lympoedema Diagnosed?

PART 3 –What is the treatment for Lymphoedema?

 

Blog by Alyaa Mohamed Mokh’ee (Physiotherapist)

Total Physiocare now has Lymphoedema Therapists throughout all our practices Heidelberg, Reservoir, Footscray & Camberwell