What Is Lymphedema?
Lymphedema is a chronic disease resulting from a malfunction in the lymphatic system. This condition is characterized by an abnormal build-up of lymph fluid in the fatty tissues under the skin, causing swelling and discomfort. The lymphatic system collects excess fluid, proteins, and toxins from the cells and tissues and sends them to the bloodstream. When the lymphatic system does not work well or if there is an obstruction in the lymphatic system, the body accumulates fluid and may start to swell.
What Are the Possible Causes of Lymphedema?
Several factors can cause lymphedema, including:
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Breast Cancer Surgery: This surgery sometimes includes the removal of lymph nodes under the arms and damaging nearby lymph vessels.
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Radiation Therapy: This therapy may cause scarring and damage to the lymphatic system, inflaming the skin and putting pressure on the lymphatic circulation system.
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Trauma: Sometimes, trauma to a particular body area can damage lymphatic vessels under the skin, causing lymphedema.
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Pelvic Surgery: The surgical procedure to remove pelvic lymph nodes may cause lymphedema.
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Infection: An infection can increase lymphatic system damage.
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Obesity: People with obesity may have extra fat that puts too much pressure on lymph nodes and vessels, affecting lymphatic drainage.
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Blood Vessel Problems: Chronic blood vessel issues may happen when something affects the blood vessels, resulting in lymphedema.
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Lack of Physical Activity: The leg muscles pump up lymphatic circulation. Due to a sedentary or inactive lifestyle, one may have swelling in the legs.
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Heart Diseases: People with heart problems, particularly congestive heart failure, can develop lymphedema.
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Kidney Diseases: If the kidneys do not function well, the body may have difficulty removing fluid. The excess fluid accumulation may cause swelling that leads to lymphedema.
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Tumors: Tumors can block lymphatic drainage.
How Does Lymphedema Affect Normal Body Function?
Swelling from lymphedema usually develops in the arms or legs but can also affect the other body parts, including the face, neck, trunk, abdomen, or genitals. Lymphedema can be painful and affect one's ability to manage daily activities. Many people with lymphedema may feel self-conscious about how lymphedema changes their appearance.
Is Lymphedema a Life-Threatening Condition?
Lymphedema is often a long-term or chronic condition that can sometimes become severe and cause serious health problems. If someone has lymphedema, one may be at risk of developing infections that start in the skin. These infections can be life-threatening. Rarely, it may also lead to lymphangiosarcoma, a rare type of skin cancer.
What Are the Types of Lymphedema?
Lymphedema is categorized into two types:
Primary Lymphedema - It is a rare, inherited condition mainly resulting from an error in lymphatic development. It affects about one in 100,000 children. Lymphedema from these conditions can occur at these ages:
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Infancy: Babies may be born with Milroy's disease, an inherited type of lymphedema.
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Puberty, Pregnancy, or Until Age 35: Lymphedema praecox can affect individuals going through puberty, during pregnancy, and up until age 35.
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After Age 35: Lymphedema tarda, a rare, late-onset lymphedema, can cause lymphedema, with swelling limited to the legs.
Secondary Lymphedema - This can happen if the lymphatic system is damaged from trauma, surgery, or radiation therapy. It is most common in individuals who have undergone breast cancer treatment. However, not everyone who has breast cancer treatment develops lymphedema. Secondary lymphedema is rare in children but is responsible for the disease in 99 percent of adults.
What Are the Signs and Symptoms of Lymphedema?
Knowing the signs and symptoms of lymphedema is essential to identify and treat it immediately. Common signs and symptoms of lymphedema include:
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Swelling in part of the body, including the face, neck, trunk, abdomen, or genitals. Swelling is the most common symptom of lymphedema. It may develop slowly.
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One cannot see or feel the veins or tendons in the hands and feet.
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Skin feels tight or stiff, changing in texture.
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The skin appears puffy, red, or hot.
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The arms or legs are slightly different sizes.
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New aching, numbness, tingling, or other discomforts in the affected area. The area can also feel uncomfortably heavy or full.
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Unusually tight or inflexible joints (such as the hand, wrist, or shoulder).
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The clothes or jewelry fit more tightly than usual. For example, collars, rings, watches, or bracelets feel tight even though one may not have gained weight.
What Are the Stages of Lymphedema?
The severity of lymphedema is usually described by its stage:
Upon diagnosis, the doctor identifies which stage best describes the lymphedema and plans treatment accordingly. The doctors use the following staging system:
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Stage 0 (Latent or Subclinical Stage): In stage 0, the affected body part may feel swollen, tight, and heavy but without exterior signs of swelling. There may be a generalized aching or a "strange feeling."
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Stage 1 (Reversible Lymphedema): This stage is typically described by occasional swelling that goes away upon elevating the affected area. The edema is soft and may leave an impression when pushed on the skin. This type of edema is called pitting edema.
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Stage 2 (Irreversible Lymphedema): Loose, disorganized collagen tissue deposition occurs at this stage. The affected area of the body is almost always swollen, and the skin may feel firmer than the surrounding area. Without treatment, no matter how long the person elevates or compresses the affected body part, it will not return to baseline contour and volume.
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Stage 3 (Lymphostatic Elephantiasis): The affected area has extensive swelling with changes in the skin, such as changes in color and texture. Skin changes can develop, such as thickening, hyperpigmentation, fat deposits, increased skin folds, and wart-like growths. The skin becomes susceptible to deep, poorly healing wounds and is at risk of infection.
How to Get Rid of Lymphedema?
Lymphoedema is a progressive disease. Therefore, early diagnosis and treatment are paramount. While there is no cure for lymphedema, so one cannot get rid of it. However, there are several ways to treat lymphedema so it does not affect the quality of life. Lymphedema treatments may vary depending on the condition's cause and severity (or stage). Treatments can include physical therapy or other treatments to keep lymphatic fluid moving and decrease swelling and pain. The doctor can also prescribe antibiotics for infections or pain medications.
Physical Treatments: These include the following:
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Compression Garments: These may be socks, sleeves, or wraps with pressure to help move fluid from the tissues into circulation. These garments help with drainage and reduce swelling but can also increase the risk of lymphedema complications.
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Physical Therapy: This involves a gentle, light lymph massage to stimulate lymph flow. This is called manual lymphatic drainage (MLD).
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Bandage: After MLD treatment, wearing a customized compression sleeve or elastic bandage on the swollen areas of the body can help prevent fluid accumulation.
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Arm Pump: Applying an arm pump often aids in keeping the fluid moving in the lymphatic vessels so that it does not build up in the arms. These pumps may also reduce lymphedema complications.
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Exercise: Physical exercise is essential to improve lymphatic drainage and restore flexibility and strength.
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Elevation: Gravity contributes to lymphedema symptoms. Keep the affected area of the body elevated as much as possible. Doing so allows gravity to help drain the collected fluid.
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Diet: Eating a balanced diet and maintaining body weight is essential to treatment.
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Skincare: Practicing meticulous skin care is critical to protect the affected body part from secondary skin infections.
Surgery: Surgery might be necessary if nonsurgical treatments fail to help the lymphedema symptoms or if the lymphedema has progressed to advanced stages. Surgical options can include physiological and excisional procedures. These procedures aim to restore lymphatic flow. Unfortunately, surgery is not a complete cure, either.
Physiological Procedures:
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Lymphatic Bypass Procedure: In this surgical procedure, the surgeon connects and reroutes lymphatic vessels and veins, so they avoid blockages and let lymph drain into the body's venous system. This outpatient procedure has minimal incisions and very little blood loss.
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Lymph Node Transfer: This involves replacing damaged lymph nodes with healthy lymph nodes taken from other areas in the body, making a new lymphatic system for the affected area of the body by lymphedema. This reduces swelling.
Excisional Procedures:
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Liposuction: The affected tissue can be removed.
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Charles Procedure: This is a more invasive, usually recommended for advanced stages. The surgeon surgically removes affected tissue and uses a part of it as skin grafts to repair the area.
Conclusion
Lymphedema is swelling that develops in various areas of the body due to malfunction in the lymphatic system. This chronic condition commonly affects the arms and legs but may also involve other locations. There is no cure for lymphedema, but doctors can recommend treatments that can help relieve lymphedema symptoms. In addition, one can take steps to control the symptoms and make it easier to live with lymphedema. Little lifestyle changes such as eating a healthy, well-balanced diet and regular exercising can make a significant difference.
