Lymphedema Month is in March! To spread awareness, we talked to our very own, Lauren Erickson. As a Lymphedema Therapist, Lauren talks more about the condition and addresses the most frequently asked questions to be aware of. Consult with your doctor, or contact Lauren at Phelps Memorial Therapy Center with any questions you may have. 308.995.2865.
Q: What is Lymphedema?
A: It's inflammation that your lymphatic system does. Basically the Lymphatic System is designed to get away like protein cancer cells, cell debris, and fat. Lymphedema is when there is a breakdown in the Lymphatic System and it can’t get rid of it. There are different stages - it could be secondary to trauma, cancer treatment, surgery, a poor cardiac system. Sometimes if their cardiac system can’t keep up their Lymphatic System breaks down, so a lot of different things can cause it. Stage zero is if there’s a lymph node effect, so if somebody has breast cancer and has a lymph node removed or they have a car accident where they hit their deep abdominals, or they have some type of surgery and lymph nodes are removed, you’re already at stage zero because your Lymphatic System has to work around that. Stage One is when they might feel a different sensation in their limb. I have patients, even if you don’t see a lot of swelling, they might have an achy in that limb where the lymph nodes were affected. Think of two sponges, they might look the same, but if this one has more fluid, you visibly can’t see that it’s different, but it feels different and heavier, so I try to educate people before they go through their treatment or before a doctor diagnoses it to discuss what they can do after treatment or surgery to keep them from progressing. Lymphedema is a secondary swelling that the Lymphatic System can’t get rid of so your heart and your cardiovascular system tries to get rid of the water. The Lymphatic System is similar to your immune system.
Q: How can I tell if I have Lymphedema?
A: A lot of times it will be that feeling of swelling first. I have patients who don’t have that visible swelling but they will say, ‘My leg feels a little bit achy,' then I will get a little more medical history. With cancer, it can be both legs. It can be depending on the side, they usually say they feel the swelling. If it’s Lymphedema, normally it starts lowers because your body is trying to pull it back up so you’ll see a lot of swelling in the feet, the legs, sometimes upper thigh - it depends on the cancer. It’s patient feeling; what they perceive or their objective report. Sometimes before they see me somebody has caught it and then sent onto me because they see that visible swelling. If you let it go too long, it’s going to be harder to reverse or get contained, but Lymphedema is a chronic condition. There’s no guarantee it won’t get worse, but there’s certain things you can do to help it keep from progressing.
Q: Am I at Risk of Getting Lymphedema Following My Breast Cancer Treatment?
A: Any type of cancer treatment. Breast cancer is a little more prevalent of what we see as well as head and neck, just because of the tissue that’s radiated or chemo can affect the system. I would say any type of cancer, you’re at risk for getting it and that’s why we do a lot of education to patients before, during, and after treatment about things they can do to keep from experiencing it. It can be any kind of surgery. After knee replacement, trauma, it’s secondary to cancer, etc., a main precursor to when we know someone will get Lymphedema is they have a history of cellulitis, that’s a main trigger. That’s one of the first questions I ask somebody is if they have cellulitis because that’s indicator they could get Lymphedema.
Q: Will Exercise Help with Fighting Lymphedema?
A: Yes, we tell anybody that’s ready to get back into exercise. I’ve had breast cancer patients go back to CrossFit. It used to be after cancer treatment you couldn’t lift more than 5 to 10 pounds for life, but we’ve realized that now we go with the saying that, “start low, go slow”. So for all of my patients, we want to make sure they have full range of motion. We check their strength, take measurements before and after treatment of the arm and the trunk, then they will start exercising and come back to be remeasured to make sure we aren’t taking in some of that fluid. I tell patients that there are specific exercise programs that are probably better than others, but in any case – start low, go slow. I usually have them get permission from their primary doctor or their oncologist before we start something really extensive. The best treatment I have found for Lymphedema treatment is what's called wrapping. We will do the wrapping or sometimes patients will wear garments to contain that fluid. We also recommend getting in the water; we get a lot of patients in the pool. Aquatic therapy is the best thing secondary to having a garment on all the time. So I will recommend especially if it’s lower extremity swelling water walking, aquatic therapy. If it's upper extremity, I like to have them do range of motion exercises at home before we start adding weight. So exercise is great, but it also depends on how the rest of their body is doing, too. Between getting that lymphatic fluid to move and all the other fluid, you might overload their heart of their lungs so we want to make sure we understand their past medical history also. But exercise in any case is the best medicine.
Q: What is a Recommended Treatment for Lymphedema?
A: Depends on the stage. A lot of times we start out with manual lymph drainage (MLD). We find a lymph nodes that are affected. We either do it here in the clinic where I show them or I give them a handout to show them how to do it themselves. If it’s really scarred down, sometimes we’ll do the MLD before and then we do compression bandaging. We can actually wrap limbs and they wrap for 24-48 hours and that muscle movement will help the lymphatic system push the fluid out. A lot of times people don’t like to get bandaged because it is really restrictive and then it’s hard to shower and do daily tasks, so I don’t bandage everyone, but the gold standard treatment would be MLD, bandaging, and fitting somebody for a garment. Even though you can get the swelling down to a certain point, you’re not going to get rid of it completely since it’s a chronic condition. If they keep it compressed, it’s going to help contain it. If they go and do a bunch of exercises without something on, it’s really taxing on your Lymphatic System and then they can have a rebound effect. Usually I see a people a couple times a week for 4-6 weeks to make sure we’re on the right track.
Consult with your doctor or contact Lauren at Phelps Memorial Therapy Center if you have any questions. 308.995.2865.
