Small lymphatic capillaries spring up in almost all tissues of our body. The lymphatic system is similar to the circulatory system, but instead of blood, this system transports lymph.
The lymph drains proteins, waste products, and fluid from tissues. Lymphatic capillaries merge into larger lymphatic pathways that come together in lymph nodes, also called lymph nodes. These are located mainly in the neck, on the collarbone, under the armpits, in the abdominal cavity and in the groin. At the level of the chest region, the lymph is returned to the circulatory system.
Lymphedema is chronic swelling, usually of a limb, that occurs as a result of an imbalance between the supply and removal of fluid. When the lymphatic system is abnormally formed or damaged, protein-rich fluid (lymph) accumulates in and under the layers of skin, resulting in swelling (edema). This in turn leads to an increase in blood flow to the area as the body tries to compensate. As a result, the limb feels heavy, warm and is prone to recurring infections cellulitis.
The symptoms that may result are:
- fatigue and heaviness
- Restrictions in movement
- limitations in daily functioning
- skin abnormalities and infections.
There may also be cosmetic concerns for many people with lymphedema.
The causes are very diverse, e.g. after surgery, plastic surgery, radiation, tumor growth, trauma, wearing a prosthesis, infection, chronic venous insufficiency (varicose veins), medication use. These are all causes of secondary lymphedema.
A primary lymphedema is congenital. From birth there are then fewer lymphatic pathways present which can cause swelling in the course of life. Sometimes this is triggered by an infection. Lymphedema occurs in mild form between the ages of 18-35, more extensive form sometimes from childhood, and can often end up being bilateral.
Most forms of lymphedema are not hereditary, although predispositions can often exist in a family. In the first years, the swelling is often not recognized as such because it is still present in varying degrees. Yet there is already a beginning of lymphedema whereby a treatment is desirable. Only later will the swelling remain permanently present.
Lymphedema occurs relatively often after cancer treatment. Have you had lymph nodes removed or radiated? Then this can reduce the drainage of water and waste products. Depending on where the lymph nodes were removed or damaged, lymph fluid may accumulate in:
- arm (lymph nodes in the armpit)
- chest (lymph nodes in the armpit or behind the breastbone or collarbone)
- leg (lymph nodes in the groin/lower pelvis)
- abdominal wall (lymph nodes at the base of the pelvis)
- pubic area (lymph nodes in the groin)
- penis and scrotum (lymph nodes in the groin)
- face and neck (lymph nodes in the neck)
Surgery and radiation may cause lymphedema separately. The risk of lymphedema is greater when you have both surgery and radiation in a lymphatic area.
Lymphedema can develop soon after treatment or for years afterwards. The longer the surgery/radiation has been, the less likely you are to develop lymphedema.
What treatments are there
It is important that you see your doctor who will examine you and decide the best course of action. You may be referred to other trained professionals for specialist advice. There are a number of treatments available to help reduce swelling and maintain a healthy limb.
- Skin care to maintain good skin condition.
- External support and compression using elastic compression garments help prevent new lymph formation, they also help with lymphatic drainage.
- A program of exercise and movement can help maximize lymphatic drainage.
- Simple lymphatic drainage based on the principles of manual lymphatic drainage using simple hand movements that can be performed by the patient, caregiver or therapist.
- Intermittent compression pumps (IPC) Pressotherapy.
Use of a pressotherapy system
The Nymph System consists of a pump and one or more cuffs, which are easy to use, safe and effective for edema (lymphedema). It is important that you follow the instructions given by your nurse, therapist or doctor for treating edema.
Before using the system, remove any bandages or compression stockings. Make sure you are in a comfortable position, if necessary, place a cylindrical cotton bandage or stockinette on the affected limb. Place the cuff on the edematous limb to be treated and connect the cuff to the pump.
Set the pump parameters for lymphatic drainage according to your physician’s advice, then turn on the pump.
The cuff alternately inflates and deflates, providing a gentle massage. This stimulates blood and lymph flow in your affected limb. If the pressure is too high and you feel discomfort, you can reduce the pressure setting on the pump. This can be done even during the therapy session already in progress.
It is important that you follow the instructions given to you regarding the duration and frequency of use. An edema therapy session lasts between 30 and 90 minutes.
Once the edema treatment is complete, the cuff and any cotton bandage should be removed. If you are wearing compression garments, you can put them back on. Experience over many years has shown that people using this system have experienced very few problems. However, if you become short of breath or if your limb becomes swollen or painful, or if the skin becomes red and inflamed during treatment, you should stop immediately and inform your doctor as soon as possible.