Lymphedema

Lymphedema is swelling caused by an abnormal build-up of lymphatic fluid in a part of the body. Lymphatic fluid is also called “lymph”. Like blood, it flows throughout the human body. It carries white blood cells, antibodies and nutrients. It helps with the elimination of waste, with maintaining the balance of liquids in the body and with the body’s immune defence.

Lymphedema is a chronic disease that can be controlled.

There are two types of lymphedema:

• Primary lymphedema is present at birth or develops later for unknown reasons. This type of lymphedema is quite rare
• Secondary lymphedema, which generally presents in the years following cancer treatment, including surgery and radiation therapy, or as a result of venous insufficiency and morbid obesity.

The main symptom of lymphedema is swelling in the part of the body affected.

Other symptoms may accompany this swelling:

• A feeling of heaviness or tightness
• Pain
• Hardening of the skin
• Decrease in the flexibility or mobility of the affected body part
• A feeling that clothes or jewellery are too tight

Treatments enable you to control the symptoms of lymphedema and to prevent numerous complications. Your doctor will suggest the appropriate treatment according to the status of your health.

Treatments to reduce swelling

The conventional treatment used to reduce swelling is decongestive lymphatic therapy (DLT). DLT is administered by a certified lymphedema therapist.

It involves:

• Multilayer compression bandaging
• Manual lymphatic drainage (MLD)
• Skin care
• Special exercises
• Self-management

Some therapists may offer modified versions of DLT, for example, with no MLD, with an alternative to multilayer bandaging (ex., two-layer system, Velcro-adjustable clothing).

Treatment to control swelling

Once the swelling has been reduced to the maximum, it is necessary to wear a compression garment during the day and sometimes at night. This garment should be worn on the long-term. It helps control the swelling and prevents numerous complications.

Compression garments must be worn only upon recommendation of a physician. They must be adjusted by a specialist.

Reimbursement of bandages and compression garments

People with lymphedema can be reimbursed for a portion of the cost of multi-layer bandages and compression garments. To find out more, check out the Compression garments for lymphedema  page on the Régie de l’assurance maladie du Québec (RAMQ) website.

If left untreated, lymphedema can:

• Cause the swelling of the part of the body affected
• Increase risk of infection or appearance of sores
• Result in difficulties performing daily tasks
• Cause psychological distress

You can reduce the risk of lymphedema by following these recommendations:

• Engage in physical activities that match your interests and abilities. Start slowly and gradually increase the duration or level of difficulty of the exercises
• Maintain a healthy weight
• Prevent any compression that cuts off circulation or puts excessive pressure on your limbs by avoiding:
  • Shoulder bags
  • Very tight clothing and jewellery
  • Crossing your legs
• Reduce your body’s exposure to extreme temperatures by avoiding the following for instance:
  • Intense cold
  • Long periods in heat (hot tubs and saunas)

When you have lymphedema, you can watch your health by following these recommendations:

• Watch for signs such as redness, swelling, irritation, itching or a rise in temperature any part of your body
• Protect the skin of affected body part to avoid risk of infection. Wear gardening gloves for instance

Anyone who has undergone surgery, experienced trauma or who suffers from chronic venous insufficiency or morbid obesity is at risk of lymphedema. Radiation therapy increases the risk. The more invasive the treatment, the higher the risk. People who have undergone surgery in the armpit or groin are especially at risk.