Information about Lymphoedema

Lymphoedema (lymphedema) is an ongoing condition, resulting from a basic lack of lymphatic function. It causes swelling and can never be completely 'cured'. It can most certainly be very greatly improved - so that the limb often becomes essentially 'normal', at least in size. Nevertheless, one must always remember it still has this underlying deficiency, is at risk, and must be protected from injuries.

There are a number of possible treatments, many of which can be used together, and indeed compliment each other when used concurrently. Many, and their combinations, are available from therapists trained at courses following the protocols of Complex Physical (Lymphatic) Therapy (Casley-Smith method) initially taught by The Lymphoedema Association of Australia in conjunction with the University of Adelaide. These are:

• Complex Physical (Lymphatic) Therapy (C.P.T.) also called Complex (Combined) Lymphatic Therapy (C.L.T.) or Complex Decongestive Physical Therapy (C.D.P.T.)

• Drugs and diet  

• Compression bandaging

• Compression garments

• Special exercises, and self or carer assisted massage

• Low level laser therapy a later addition to the above or

• A combination of all of these - which has been shown to be best.

 

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Diet for lymphoedema

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The website sponsor Poppy Lane Skin Care & Lymphedema Clinic provides educational resources, reference materials, teaching of specific skills for training, assessment and treatment of lymphoedema. Research and treatment methods are based on the Casley-Smith Complex Physical (Lymphatic) Therapy protocols (CPT). Resources including Laser and dietary advice are also incorporated into treatment. Self help information and advice for homecare is available by direct consultation, email and phone. All information and treatments are designed to help reduce the swelling of lymphoedema or lipoedema. 

The information provided at this website is not a substitute for professional medical care and is provided for educational explanation and information purpose only. It is advised you always consult with your medical practitioner with any medical condition prior to commencing any treatment.

• What is lymphoedema?     Laser therapy    The cause of lymphoedema    Diagnosis of lymphoedema

Frequently asked questions about lymphoedema.  

What is the cause of Lymphoedema?
Research information indicates all lymphoedema is caused from a failure of the lymphatic system to collect and remove proteins from the fluids of your body tissues. These fluids are medically termed 'interstitial fluids' and they are contained in the spaces between the cells of your body tissues. 

When proteins remain trapped in body tissue fluids for a prolonged period of time they act, by their osmotic action, like a magnet for other watery body fluids. This causes oedema or lymphoedema swelling of the body tissues.

The swelling of lymphoedema causes the secondary conditions of tissue fibrosis, pain and general discomfort that most people suffering lymphoedema know only to well.  

What is the difference between Primary and Secondary Lymphoedema?
All lymphoedema has the underlying problem of reduced lymphatic transport capacity which results in an inability to remove sufficient protein from interstitial fluids (body tissue fluids) located in between and bathing the cells of the body tissues.

Secondary Lymphoedema

Secondary lymphoedema is caused by trauma that causes damage to the lymphatic system. This trauma may be the result of an accident or surgery (surgical intervention). 

In all cases of trauma, should lymphatic transport become permanently compromised and unable to transport sufficient protein rich lymphatic fluid named 'lymph' (that is essentially concentrated interstitial fluids) equal to the number of proteins deposited into tissues from the blood circulation, then, unless remedial actions are taken, there is a distinct possibility/probability of lymphoedema. 

Lymphoedema should not to be confused with the fluid of post surgical swelling. this type of swelling may last from a few weeks to many months

The most promoted causes of lymphoedema are from Breast and Ovarian Cancer surgery. Swelling in these cases may affect a patients arms/chest or legs respectively. This it must be remembered, is not the only cause of secondary lymphoedema.

Primary Lymphoedema

Primary Lymphoedema occours where lymphatic function is insufficient for no particular reason. 

This condition may be apparent at birth or with some it can become apparent later in life. The most common  times for noticing primary lymphoedema symptoms can be at birth, around puberty and in mid life.

Is lymphoedema reversible?  
Reversible lymphoedema is often explained in dictionaries as: 'lymphoedema that will reduce in size overnight with elevation of an affected limb' This description must be used with caution. 

Results of research trials indicate in most cases the action of limb elevation overnight alone is insufficient to control the gradual progression of lymphoedema swelling to a more permanent and worsening condition.

Lymphoedema swelling is normally long term reversible and controllable with regularly administered ongoing care by patients themselves, and where available, the help of carers. 

The object of all ongoing care is to remove excess protein trapped in a lymphoedema affected limb and return it back into the blood circulatory system. By doing this protein equilibrium in body tissues can be returned and the oedema/swelling will reduce.  

A low cost starting point: By eating more foods that strengthen the circulatory system and less foods that tend to block the circulatory system it becomes possible to help slow, reduce and reverse swelling.

More information is available here  

What is a cure for lymphoedema?  
A fully permanent cure for lymphoedema does not seem possible until a way to regenerate an insufficient or permanently damaged lymphatic system is found. Ongoing regular treatment is required for lymphoedema to be contained. 

All lymphoedema related oedema, fibrosis and other associated conditions are reversible and maintainable to differing degrees with properly administered treatments. Many of these treatments can be performed a patient at home in conjunction with professional clinic therapy. 

We find the results are best when a combination of therapy with self help and assisted therapy is  proving to be most beneficial in reducing oedema and swelling.   

How can I control Lymphoedema?   

The best treatment and place to start making swelling reduction:

• How a positive attitude can help.
  Having a positive attitude helps with lymphoedema control.  
  
  A more relaxed mindset achieved from a positive outlook to life promotes better muscle contraction and relaxation. This in turn increases varying tissue pressure which in turn stimulates lymphatic function and increases lymphatic flow to help control and reduce lymphoedema. 
  
  The flow on effect from a positive attitude is a real low cost option to assist swelling reduction.
  
  When you are feeling 'uptight' muscles become and stay contracted. This causes restricted movement and subsequently lowered varying tissue pressure. In turn this restricts lymphatic function and worsens your condition. 
  
  A smile and a happy face cost nothing to implement.  The results of a smile and positive attitude helps you to be more relaxed. This simple action, when combined with other lymphoedema therapy can provide amazing and ten fold results. 
  
  A combination approach to lymphoedma control works best.
  
  

• Eat the most beneficial foods. 
  The next effective low cost option you have to assist lymphoedema swelling reduction is to eat foods to help improve your circulation, both blood and lymphatic. The simple step can help prevent and improve the conditions causing your lymphoedema. 

  After you begin eating better choice foods you may enhance results by combining with other beneficial complimentary therapies at home or at a clinic or a hospital. 
  
  We recommend using the Principles of Complex Physical (Lymphatic) Therapy (CPT)- Casley-Smith Method which have a fairly well proven track record to assist with lymphoedema control.
  
  See the diet page for more information about diet or continue to read on for more about Complex Lymphatic Therapy.
  
  

• Perform CPT (Complex Physical (Lymphatic) Therapy). 
  Simply explained, CPT consists of specialised lymphatic drainage massage, laser therapy and multi-layered compressive bandaging to reduce the size of an affected limb. Compressive bandaging therapy normally takes between 1-3 weeks to administer.  
  
  Once a course of gradient compressive bandaging is complete, then compression garments are required to maintain the smaller size
  
  

• Compressive Bandaging
  
  As compressive bandaging therapy does restrict your movement, it is wise be prepared for this situation. Have some meals pre-prepared and stored in the freezer so you spend less time in the kitchen.
  
  It is also good to have friends available to drive you to and from the clinic if having clinic treatment. Bandages will affect your driving ability. 
  
  CPT Bandaging can also be performed by yourself and a helper at home. Check its suitability for you with your doctor. If not suitable then do not proceed. You will also need in conjunction with bandaging, to perform at minimum a few minutes of self massage prior to each time you bandage.  
  
  Books explaining and showing the bandaging process for educational purposes are shown at this website on the products page.  
  
  

• Compression Garments.
  To maintain reduced sizes after a course of compressive bandaging fitted compression garment/s must be worn indefinitely. 
  
  Compression garments help maintain the extremely fast reduction of an affected limb that occurs when compressive bandaging is applied. 
  
  Well fitted compression garments are comfortable to wear. The feeling of compression with the knowledge you are more in control of swelling in a limb can be very reassuring.  
  
  A doctor or therapist will provide information about compression garments. All compression garments must be comfortable to wear and not too tight. Garments that are too tight may compromise the circulation to become part of the problem.
  
  Compressive leg garments for lymphoedema should in most cases always be a minimum of thigh high.  
  
  Without wearing compression garments after full CPT therapy the limb will quickly regain its former larger size. 
  
  

• Dietary supplements.
  Food supplements can be helpful where dietary intake is inadequate. More information is at the Products page
  
  

• Skin care for lymphoedema:
  Skin is best kept supple and smooth without roughness of texture or cracking. By protecting your skin against the elements your body is more easily able to maintain its natural protective integrity to repel unwanted organisms

  Anti bacterial cosmetic skincare creams to help protect against the elements to aid the appearance of smooth skin are shown on the Products page.  

   

Many patients say 'the time put aside for full CPT treatment is worth any short term inconvenience for the long term gain achieved'

What is Complex Physical (Lymphatic) Therapy?

• Lymphatic Drainage Massage 
  Low Level Laser Therapy (LLLT)
  Gradient Compressive Bandaging 
  Skincare 
  Diet 
  Food Supplements
  Exercise 
  Self Massage 
  Compression garments 

All the above form part of CPT Lymphoedema Therapy.  

Contact Juliet at julietgeorge@lymph.com.au for more information about home care plans and clinic treatment using CPT therapy.

More FAQ about lymphoedema:

What causes infections with Lymphoedema?
Due to a build up and stagnation of fluid in your body tissues, infection of a lymphoedema affected limb is a constant threat. 

The infections are often bacterial and/or fungal infections. Pathogens causing infection in many cases enter body tissues where skin integrity is reduced such as from dry flaky skin or around cracked nail cuticles . 

Worst case scenarios to control infections require hospitalisation for a course of intravenous antibiotics. 

Infection can be caused by common bacterial agents located on the outside of your skin. Staphylococcal infections are quite common. These infections are usually well controlled by oral administration of penicillin based drugs when administered promptly at the onset of infection. 

Cellulites infections, if not treated soon enough often require a course of intravenous drugs. Hospitalisation is required for their administration. To reduce the possibility of hospitalisation, talk to your doctor about having antibiotics on hand ready to take if you have lymphoedema and are at risk of infection.

Fungal infections are difficult to diagnose and detrimentally affect a lymphoedema affected limb. 

From experience noted in this clinic, spider bites often appear to be the source of fungal infection and in combination with lymphoedema will reduce the health of lymphoedema affected limbs.

The most effective options for controlling affected or at risk limbs from infection is (a) take preventative measures to protect against the elements to keep your skin, unbroken smooth and supple, (b) if the skin get quickly hot and/or red streaky, see your doctor or hospital outpatients unit quickly to obtain and take oral antibiotics straight away.

As a preventative measure you could speak with your doctor, and if your doctor deems appropriate, arrange to have antibiotics on hand for emergency use. Always see a doctor quickly at onset of any suspected infection.

Which drugs are used for lymphoedema?
The most effective prescription drug found for reducing lymphoedema had possible adverse side effects with a percentage of people and was deregistered and withdrawn from the market.

When swelling is excessive, diuretic drugs may be prescribed by your doctor. These drugs may provide a short term solution to reduce swelling. 

As diuretic drugs do not remove excess protein from the interstitial fluids they are not normally a long term solution for lymphoedema swelling reduction. 

You may be prescribed diuretic drugs for purposes other than lymphoedema. The subject of diuretic drugs is best, and should be discussed with your medical practitioner for your health and safety.
 

Cancer and Lymphoedema:
After cancer surgery and radiotherapy the possibility of secondary lymphoedema developing may increase over time. This is so for some people but not all people. To be aware talk to your doctor about this

By being aware of symptoms, should they occour, makes for early intervention and easier control. Lymphoedema awareness is often an afterthought of cancer treatment so it pays not to become complacent.

Research from trial and observation lead me to believe there is real benefit to be made by eating foods and employing therapies that help stimulate good circulation. This action can be a preventative measure not only for lymphoedema control, but for better health and the general overall wellness of us all. 

The information provided at this website is not a substitute for professional medical care and is provided for educational explanation and information purpose only. It is advised you always consult with your medical practitioner and gain their approval for treatment with any medical condition prior to commencing any treatment.

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