Dispelling Myths About Lymphedema
Lymphedema is the swelling of a human body part caused by an abnormal accumulation of fluid, proteins, and cellular waste in the tissues under the skin. https://fightlymphedema.com/ It occurs when there is a problem with the lymphatic system caused by one of the factors below:
-The failure of lymph vessels to develop properly
-Damage to lymph vessels by trauma, surgery, or infection
-Removal or destruction of lymph nodes, usually during treatment of cancer
Most of the advancements made in the understanding and treatment of lymphedema result from research on those who acquired lymphedema as a complication of breast cancer treatment.
Here are some common misconceptions about lymphedema:
Myth 1: It is an incurable condition. https://www.theflatratemovers.com/ While it can be managed, lymphedema is a lifelong condition that will not go away over time. In fact, because it is a chronic progressive condition, even mild cases can eventually escalate and have serious consequences if not properly treated.
The gold standard for lymphedema treatment is complete decongestive therapy, which consists of two stages: a clinical phase where a lymphedema therapist performs manual lymph drainage and bandaging, and a self-care phase where the patient or caregiver performs the daily massage and bandaging. The clinical treatment may only take 4-6 weeks, but managing lymphedema is an ongoing process.
Myth 2: It will only develop within the first five years after surgery and radiation. Although we wish this were true, people can develop lymphedema at any stage in life. I have heard of a cancer survivor who 30 years after her treatment developed lymphedema after reaching up to pull down a garage door. It may be uncommon, but it can happen.
Myth 3: Lymphedema will make one's arm huge. One-size-fits-all is not true for lymphedema. Like cancer, lymphedema has various stages. Stage I is mild, Stage II moderate and Stage III severe. I've seen pictures of a lymphedemous leg grossly misshapen, and I've seen cases where I could hardly tell the person had lymphedema.
Myth 4: The sentinel node biopsy that only removes a few lymph nodes stops lymphedema from happening. The procedure, while reducing the incidence of lymphedema, has not eliminated it. Genetic predisposition to any disruption of lymphatic flow may tip the scales.
Myth 5: A person at risk for lymphedema or who has it should not carry heavy objects. This has recently been disproven. In fact, gradual lifting of weights with a compression garment helps with lymphatic flow.
Myth 6: If your limb starts to swell you can wait a while to get therapy. If you notice any swelling in a limb after removal of lymph nodes, even after a sentinel node biopsy, see a surgeon right away. The earlier you catch it, the better. If the doctor does not listen, go to another M.D. who will. And if you are diagnosed, insist that you get a prescription for lymphedema therapy.
To reduce the risk of developing lymphedema, many therapists advise patients to have their arm fitted for a compression sleeve to be donned during plane rides longer than four hours. But newer findings indicate that cabin pressure at high altitudes may not make a difference in swelling. In addition, survivors may wish to wear the sleeve when lifting heavy objects with that arm. One should consult the National Lymphedema Network or Step-Up, Speak Out to get current, reliable doctor-approved advice on risk-reduction practices.
While certain triggers have been found anecdotally to bring on lymphedema (such as long plane rides or repeated puncture wounds), many experts in lymphology now surmise that those who develop lymphedema do so because of a genetic predisposition. Also, some people are born with more lymph nodes than others, providing a more protective effect.
Notwithstanding myriad myths and misconceptions about lymphedema, my main advice is never to despair. You can lead a normal life after lymphedema. Some patients turn the anger they feel toward their surgeon in not informing them of lymphedema into legislative and other action to ensure more research is directed toward this under-served condition. Others start Web sites and blogs to provide needed information to patients at risk and those with lymphedema. Still others go on to live their lives without fanfare. All of these responses are valid.
For tips on breast cancer survival and management of lymphedema, visit Jan Hasak's. Jan Hasak is author of two books on breast cancer: "Mourning Has Broken: Reflections on Surviving Cancer" and "The Pebble Path: Returning Home from a Forest of Shadows." A blogger and speaker, Jan Hasak volunteers for the American Cancer Society and serves as breast cancer and lymphedema patient-advocate with the National Lymphedema Network. She also serves on the Board of the Lymphedema Advocacy Group to lobby U.S. Congress on a bill to pay for lymphedema garments and other devices.
Extra on the Pathophysiology of Lymphedema and on Lymphedema Clinics
First - The function of a lymphatic system:
The primary capabilities of the lymphatic system are the elimination of proteins of excessive molecular weight and immunological position (an infection, cancer).
In case of lymphedema, the excessive molecular weight proteins stay in the interstitial fluid, causing a rise in interstitial oncotic pressure, causing edema.
The absence of substitution (the venous system is unable to take away these proteins) explains the persistence of edema (attracted by proteins), even after diuretic therapy (which causes salt depletion with out action on proteins).
Second - implications of lymphedema:
This high protein promotes fibrosis and pores and skin infections.
The presence of proteins and degradation merchandise of collagen stimulates the exercise of fibroblasts answerable for fibrosis.
In lymphedema, there's a hyperplastic fibrosis however no ulceration, in contrast to venous insufficiency.
Bacterial dermohypodermitis or streptococcal lymphangitis complicating lymphedema frequently.
In lymphedema, the pores and skin modifications are primarily dermal (improve in thickness, water retention) but in addition hypodermic (the fats lobules of the subcutis are bigger).
Primary lymphedema of the child are often ensuing from lymphatic hypoplasia roughly extensive.
Networks are delaying substitute, in some types, medical manifestations, which will occur throughout an episode of genital life (puberty, being pregnant), trauma, surgery or irradiation.
Studies of the superficial lymphatic network in microlymphographie show a dilated lymphatic system (primary lymphedema occurs after puberty) or, either full aplasia of superficial lymphatic (congenital lymphedema type I) or superficial lymphatic ectasia (congenital lymphedema sort II).
Lymphedema will be very early, from the neonatal period or at puberty, or later after 35 years.
The diagnosis is almost always straightforward, besides within the newborn and infant (Chubby ordinary look at this age).
Secondary lymphedema is more proximal lymphatic congestion occurring near the blockage.
Upper limb, it's the classic "huge arms" after proximal to early radiosurgical treatment of breast cancer.
The first lymphedema usually start by impairment of the extremities.
Decrease limb, the event is crucial edema of upper foot, which does "non-pitting" within the early forms, this isn't constant.
The toes are pudgy, with transverse folds marked, especially at the base.
Stemmer's sign is taken into account pathognomonic of lymphedema of the lower extremity: is thickening of the pores and skin fold, highlighted by pinching the top of the second toe.
Subsequently, lymphedema clears bony ankles (filling areas retromalleolar), giving a facet of leg "publish".
It results in skin fibrosis with fibrous papules, vegetation and deep transverse folds. Other displays are possible.
Lymphedema may be suspended as much as the upper thigh.
It could additionally attain the genitals, face, or be generalized.
In main lymphedema of the limbs, just one will be reached, or each decrease limbs, both higher limbs, higher limbs and decrease limb on the identical side or opposite side.
Lymphedema of the lower limbs could reveal or accompany a losing enteropathy by malformation of the lymphatic system tract (chyloed?me, Waldmann syndrome or intestinal lymphangiectasia, lymphangiomatosis...) or an abnormality of the thoracic duct.
Kaposi's sarcoma may be preceded or accompanied by lymphoedema.
In instances of persistent venous insufficiency, lymphatic system abnormalities are observed.
The lymphatic insufficiency, initially dynamic, might over time turn into mechanical, alteration of lymphatic capillaries attributable to venous stasis.
This could explain some scientific abnormalities of submit-thrombotic syndrome and untreated older.
This could additionally explain the pathophysiology fibrosis and certain scientific abnormalities seen in persistent edema, whatever their trigger (anasarca, "elephantiasis" Tropical...).