Lymphedema Needs to be Kept Under Wraps

By Scott Welton
scottw@standard-democrat.com
While bringing attention to women’s health issues is the focus this week, there is one condition that needs to be kept under wraps: lymphedema.
National Women’s Health Week, which is coordinated by the U.S. Department of health and Human Services, kicked off on Mother’s Day and runs through Saturday.
Lymphedema is a condition in which the fluid known as lymphatic tissue builds up in an area of the body causing it to swell, according to Tricia McClarty, an Occupational Therapist and Certified Lymphedema Therapist at Missouri Delta Medical Center’s ReStart.
“It’s primarily in the arms and in the legs,” McClarty said.
There are a couple different types and causes of  lymphedema.  “Primary lymphedema is usually discovered at birth or shortly after,” McClarty said.  “Secondary lymphedema is the  most common type.  The reason we usually see it in the United States is due to breast cancer.”
The condition develops as a result of lymph nodes being removed in a mastectomy.  How many are removed varies depending on the type of cancer, the physician and how far the cancer had advanced, according to McClarty.  “You can be at risk if you have as little as two removed,” she said.
McClary said people don’t usually think about lymphedema until they begin to see the symptoms – but they should.  “The earlier you catch it, the better,” she said.
In the earlier stages, the limb or affected area is normal or almost normal in size upon waking in the morning, but if allowed to progress to later stages, lymphedema can result in irreversible swelling and hardened tissues.
McClarty offers a treatment for the condition called Complete Decongestive Therapy through physician referrals.
“It’s proven with research to be the most effective treatment for lymphedema,” she said.  “I get referrals from all over.  There’s only four of us in the area (trained in CDT) – two in Cape, one in Dexter.”
Phase 1 of CDT, which is the treatment phase, requires daily manual lymphatic drainage sessions which use compression bandages to force the fluid from the affected body part.
For example, if the patient has swelling in the arm, “you wrap from the fingers all the way to the shoulder,” McClarty explains. “Or if it’s in the legs, from the toes up to the swelling.”  Bandages remain in place for 24 hours during this phase.
The treatments also include exercise and massage to move the fluid.
Patients are also taught to apply the wrapping themselves in preparation for Phase 2, the maintenance phase.
Depending on how far the lymphedema advanced, the first phase can be as  short as a couple of weeks to as long as four weeks to get the swelling down, McClarty said.
Once in Phase 2, the patient will wear a compression garment on the affected body part during that day and wrap it with compression bandages at night.  Exercise, along with some self-massage, also helps to control the condition.
“We do a lot of education with the patient and the family,” McClarty said.  “The goal of the treatment is to reduce swelling, improve mobility and range of motion, prevent infections and improve their overall quality of life.”
As catching the condition and beginning treatment in early stages can make a significant difference, McClarty regularly offers education for cancer survivors at places such as American Cancer Society “Look Good Feel Good” classes.
“Some people begin noticing their clothes are tighter,” McClarty said.  Another indicator of lymphedema is “if you have some swelling or some pain,” she added.
Simply ignoring the problem and hoping it goes away is not an option, however.
“There’s no cure for lymphedema,” McClarty said.  “Once you have it, you have it.”