What Symptoms and Signs Accompany the Stages of Lymphedema?
No visible signs of swelling, usually sensations of heaviness and tightness in the affected limb. Even though swelling may not be visible, treatment usually with compression should be started to reverse the risk of worsening edema. Elevation, compression and manual lymphatic drainage may avoid progression to fibrosis.
Swelling consists of protein-rich fluid in the tissues and may become temporarily reduced by simple elevation of the limb. If left untreated, the disease can progress to Stage II. The foot may have a puffy appearance. Finger pressure may result in an impression in the skin- “pitting.”
Swelling doesn’t respond to elevation and the extremity and foot take on a spongy consistency. “Pitting” is less present. There is fibrosis in the tissue and the lower leg is permanently enlarged.
Significant increase in fluid volume, skin changes such as hardening and dryness of the dermal tissues, hyperkeratosis and papillomas occur (raised lumps in the skin). Swelling doesn’t subside with elevation. Fluid may leak from the skin or blisters may form.
Infections frequently develop in patients suffering from lymphedema and are most common in stage II and III lymphedema. Infections result in worsening of patient’s lymphedema and may also result in hospitalization with IV antibiotics.
Lymphedema is a chronic condition that can be managed, not cured, with complete decongestive therapy (CDT). CDT is a combination of manual lymphatic decompression (MLD), compression bandaging/garments, remedial exercises and meticulous skin and nail care.
What is the Treatment for Lymphedema?
Manual Lymphatic Drainage
This light, gentle massage technique helps move fluids away from the congested area into an unaffected area to reduce the swelling.
This multilayer of short stretch bandages work with the patient’s movement for further reduction of swelling. More recently, Velcro compression makes application and daily hygiene easier, and patient tolerance is excellent.
These compression garments are worn during the day to help keep the swelling down, improve circulation, and prevent accumulation of lymph fluids in the involved area.
Pneumatic Compression Pumps
This mechanical device works as a sleeve with inflatable chambers to help mobilize the fluid from the limbs.
Meticulous skin care, including the application of a low PH lotion at least twice a day and avoiding nicks, cuts or abrasions, as the affected limb is more susceptible to infection.
When used with compression, exercise utilizes the body’s natural muscle pumping action to increase venous and lymphatic fluid return to the circulatory system and out of the affected/swollen area. Recommended exercises are swimming, yoga, walking, biking and light weight training with compression, except with swimming. Avoid aggressive contact sports, exercise-to-fatigue sports or heavy weight lifting that may cause injury.
Some important tips to remember are maintaining a healthy weight, keeping hydrated with water and eating a well-balanced diet consisting of fruits, vegetables, whole grains and protein. Avoid carbohydrates when possible as well.