Lymphedema

By Amy Hartwell, MS OTR/L CLT

Life-saving breast -cancer treatments including, but not limited to, the various forms of surgical interventions, sentinel lymph node and/or axillary lymph node dissection and other treatments such as radiation treatments may lead to an impaired functioning of the lymphatic system with resultant secondary symptoms including a diagnosis of Lymphedema.  When the lymphatic system is not functioning properly, it can lead to significant impairments throughout the upper extremity including: decreased motion of the joints; impaired strength, coordination and sensation; increased pain and impaired skin integrity leading to an increased risk for wounds, all building to decrease the rate of healing and increase the incidence of infections.

Secondary Lymphedema may be defined as an abnormal accumulation of fluid following a traumatic event, due to impaired functioning or destruction of the lymphatic system; a system that works hand in hand with the venous system to remove bacteria,  water, minerals, waste products, proteins, etc. from the tissues within our bodies. A diagnosis of Lymphedema requires specialized treatment in order to stimulate the lymphatic system and evacuate the fluid out of the swollen extremity.  Lymphedema is a life-long diagnosis requiring education in ways to maintain the reduction gained with participation in Complete Decongestive Therapy, which is the treatment of choice when dealing with a diagnosis of Lymphedema. As a therapist, this is the targeted goal of therapy, to increase our patient’s quality of life.

Life Care Center of Estero specializes in inpatient and outpatient Lymphedema treatment services called Complete Decongestive Therapy. Complete Decongestive Therapy consists of several aspects of treatment including: manual lymphatic drainage techniques, the incorporation of gentle therapeutic exercise, compression bandaging,  garment fitting and patient and family education for proper skin care as well as a home exercise program for maintaining the gains made while participating in therapy services. Manual lymphatic drainage consists of stimulating the lymphatic vessels by gently manipulating the skin, allowing for re-routing of the fluid from the tissues thereby creating alternate routes for the fluid to flow out of the extremity. This is especially important due to the risk of scar tissue build-up created from surgical interventions or radiation treatments around the breast or armpit limiting movement of fluid out of the arm. Gentle therapeutic exercise is then incorporated into treatment in order to pump the fluid through the lymphatic vessels and back into the venous system for removal by the body. Compression bandaging is then applied with the use of low stretch bandages in order to create a layering effect with more compression at the hand and decreasing toward the armpit facilitating continued filling of the lymphatic channels with flowing of the fluid using the assistance of muscle pumping or exercise.  Skin care is also extremely important as the tissue has been damaged from the excess fluid. Daily hydration and cleansing of the skin is required for maintained health, prevention of infection and skin breakdown. Once the arm has reduced, a garment is fitted and required for maintained compression of the extremity to prevent the swelling from returning with education for applying and maintained use. As you can see, this process takes a combination of the therapist and the patient working together in order to obtain the desired outcomes.  Finally, educating the patient to manage their own program through the establishment of a home exercise program will ensure continued wellness with a new lease on life!

As with any new diagnosis, education is key to a maintained healthy and happy lifestyle and the professionals at Life Care Center of Estero are always happy to assist our patient’s through their breast cancer recovery and Lymphedema management process. Life Care Center of Estero’s motto is and will always be “whatever it takes and then some,” as we strive to assist our patients toward regained wellness.

Lymphedema Treatment Highlights:

• Manual lymphatic drainage
• Therapeutic exercise
• Compression bandaging
• Skin care
• Garment fitting

 

239.495.4000 | 3850 Williams Rd. | Estero, FL 33928 | www.LCCA.com