Lymphedema

from www.summitmedicalgroup.com

 Lymphedema (AKA Lymphatic Obstruction) is a condition in which the vessels of the body's lymph system fail to drain lymph fluid properly, which often causes swelling, or edema, in the affected extremity.  Lymphedema occurs when lymph nodes are removed or enlarged, often as a result of cancer treatment.  It is also caused by injury, skin infections, and congenital abnormality of the lymphatic system.  

A Physical Therapy evaluation of lymphedema includes taking a detailed history, performing a functional assesment, measuring the circumference of both the affected limb and the opposite limb, assessing the grade of the edema, measuring active/passive range of motion, and assessing strength.  Treatments for lymphedema often include manual lymph drainage, therapeutic exercises, compression, and patient education.  

an example of upper extremity lymphedema

To prevent the development of lymphedema, or to prevent the condition from worsening, it is vital that patients comply with lymphedema precautions and perform proper skin care:

Precautions

• Avoid a tourniquet effect on the affected limb, avoiding elastic bands or ACE bandages for compression.
• Avoid putting a blood pressure cuff on the affected limb.
• Avoid temperature extremes.
• Avoid hot water, saunas, hot tubs, and heat packs.
• Be careful when cutting your nails.
• Avoid cutting your cuticles during manicures or pedicures, especially at a salon. 
• Avoid needle sticks to the affected limb.
• Avoid cuts, insect bites, burns, and other injuries to the skin of the affected limb.
• Do not lift more than 5 pounds with the affected arm unless wearing a compression sleeve.
• Do not perform prolonged, strenuous resistance exercises unless wearing a compression sleeve.

Skin Care

• Keep your skin clean.
• Keep the skin of the affected limb moisturized with low pH lotion.
• Wear sunscreen when outdoors.
• Wear insect repellent.
• Wear gloves when cooking and gardening.

I have the privilege of working with a PTA who is a Certified Lymphedema Therapist.  She has a fantastic talent and her patients love her!  If you're in southern California and need a CLT, contact me! 

Here is a link to a video about rehabilitation after breast cancer surgery: http://www.cnn.com/video/#/video/health/2012/10/10/breast-cancer-rehab.cnn.