The lymphatic system carries lymph (a fluid that contains white blood cells) throughout the body. Lymphedema occurs when there is a blockage of lymph fluid in a part of the body.

Types of lymphedema

There are two types of lymphedema:

• Primary lymphedema. This occurs when a person is born with a defect in the lymph nodes or lymph vessels. It can show up at any time in life. Lymph vessels have smooth muscles in them. The muscles contract to pump lymph through the lymphatic system. If a person is born with the pumping mechanism too far apart or too close together, the lymph vessels can't pump lymph effectively. The vessels may work fine for several years or even throughout life, but if trauma occurs (for example, a sprained ankle, weight gain or pregnancy), the lymphatic system will be overloaded and lymphedema will occur.
• Secondary lymphedema. This may occur when cancerous lymph nodes (small parts of the lymphatic system that filter lymph) are treated with radiation therapy and/or surgically removed. Chronic venous insufficiency can also cause secondary lymphedema. hen lymph nodes are removed or destroyed by radiation therapy, lymph can no longer be filtered properly. Waste from the unfiltered lymph will sit in the skin. Since skin is elastic, it will continue to stretch to house the waste that is being collected by the lymph vessels.

People who have had cancerous lymph nodes removed or treated with radiation therapy are at the highest risk for developing lymphedema.

Signs and symptoms of lymphedema

The most obvious sign of lymphedema is swelling of the affected area that doesn't improve on its own with elevation. Symptoms of lymphedema include:

• pitting edema (when pressure applied to the affected area causes an indentation for some time)
• heaviness in the extremity
• pocketing of fluid in areas
• sometimes pain

Pain is not usual with lymphedema. If you experience pain, there is usually another underlying cause.

Lymphedema services at The Christ Hospital Health Network

At The Christ Hospital Health Network, we provide a specialized lymphedema therapy program. Treatment consists of complete decongestive therapy (CDT), which includes manual lymph drainage (MLD), compression, elevation and skin care. The MLD is performed by a certified lymphedema therapist.

Bandages or garments can be used for compression. However, this does not count ace bandaging. Ace bandages are not a good source of compression.

Treatment also includes education on self-maintenance with self-MLD or pump and compression garments.

To learn more about our lymphedema therapy program or to make an appointment, please call 513-585-3838.