What is Lymphedema and How is it Treated?

Nothing unusual had happened in “Janet A’s*” daily life, so she was shocked when her arm suddenly started to swell up. She went to Northwest Hospital in Randallstown, Maryland for help.

Nothing unusual had happened in “Janet A’s*” daily life, so she was shocked when her arm suddenly started to swell up. She went to Northwest Hospital in Randallstown, Maryland for help.

There, medical experts diagnosed her with lymphedema, the buildup of lymphatic fluid in one or more areas of the body. This swelling can occur anywhere but is seen most often in the arms, legs, face or genitalia. Janet began working with Cindy German, an occupational and certified lymphedema therapist who heads the Lymphedema Clinic at Northwest Hospital.**

With Cindy’s guidance and support, Janet found out that she developed the condition 25 years earlier after breast cancer surgery and that it surfaced as a result of a skin irritation that further compromised her lymphatic system.

After learning about skin care, how to bandage her arm and what exercises she could do, Janet’s arm went back to its normal size, she was able to leave the program and wear her favorite jacket again.

Janet’s is just one success story where lymphedema is concerned. Some people are born with the condition, and others develop it after surgery, radiation, trauma or an infection. To understand why this is such a challenge, you have to first understand the lymphatic system.

In order to fight disease, everybody has to have to have a strong immune system that can rid the body of bacteria and other harmful materials. To make this happen, toxins are forced out of the blood stream into the lymphatic system. If lymph nodes are taken out or are not working correctly, fluids can buildup and cause a road block of sorts. Because the body keeps producing more fluid, it continues to build up in the tissue and can cause swelling. Since this fluid cannot drain properly, the affected area is more prone to infection.

The symptoms of lymphedema include:

• Skin feeling tight
• Decreased motion in one or both hands, arm, legs or feet
• Tough to fit into clothes or jewelry on one side of the body.

If someone was born with lymphedema, the symptoms can appear all of a sudden. People, like Janet, can also develop it if their immune system is compromised because of outside influences, such as cancer, trauma and infections.

In Janet’s case, a skin irritation, caused by a change in her laundry detergent, triggered the lymphedema, but it can also be sparked by things like a change in air pressure, extreme temperatures, bug bites, scratches or cuts.

While this condition is not curable, there are many different ways to successfully treat it. Among them are compression garments, massage, certain exercises and a sequential pump, which pushes fluid out of an extremity.

In the Lymphedema Clinic at Northwest Hospital, Cindy enlists the help of medical professionals from a variety of disciplines such as wound care, breast care, urology and primary medicine to treat the whole patient.

When lymphedema strikes, it can vary from mild to severe. In the most serious form, limbs not only swell, but fluid seeps out of a person’s pores. If not treated, the skin can open, causing wounds, blisters and infections.

Because the side effects from lymphedema are visual as well as painful, helping patients both medically and emotionally is important. Having swollen limbs can feel heavy and cause poor posture. Clothes and shoes don’t fit, and a person often becomes immobile, which can also cause weight gain and low self-esteem.

However, Cindy says there is help at a variety of levels. In addition to expert medical treatment of the lymphedema, itself, there is also adaptive equipment to help someone with the tasks of daily living- such as reachers and sock donners-, re-learning how to walk again, as well as strength and endurance training.

Cindy says that she loves many parts of her job, but seeing patients blossom is what she loves most. She says watching her patients progress and seeing them be able to manage and control their lives again is priceless.

*This is not the patient’s real name.

**Cynthia German, Cindy, OTR/L, CLT, is an occupational therapist at Northwest Hospital, who is certified in lymphedema treatment and is also an instructor in the Healthy-Steps program, the only medically based program to treat this condition.