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Lymphedema and Treatment

 

By Akari Yokokawa, RMT, CDT

I wonder how many of us are familiar with the term “Lymphedema”.  It might sound like such a rare term, but unfortunately this is not a rare condition. In 2004, it was estimated that over 64,000 people have Lymphedema in Ontario, with up to one in four breast cancer survivors developing Lymphedema at some point in their life. (Lymphedema Association of Ontario)

Lymphedema is an accumulation of Lymphatic fluid in the body and manifests as chronic swelling. Some people are born with malformation of lymph vessels and/or nodes and can manifest at different points in their life (at infancy, puberty, or middle age), which is called Primary Lymphedema. Some people develop Lymphedema after certain episodes, this is called Secondary Lymphedema. Main causes of Secondary Lymphedema are; cancer treatment (with lymph node removal including sentinel biopsy and/or radiation therapy), orthopedic surgery, chronic venous insufficiency, obesity, lipoedema (increased number of fat cells, often seen in women mostly in their hips and thighs).

Lymphedema is a chronic condition with no cure, swelling progresses further and tissue becomes fibrotic, affected area would show deformities if it is left untreated. The weight imbalance could cause postural imbalance, aches and soreness in the body. The area is highly vulnerable to infection due to sluggish lymph flow, infection can be fatal if left untreated in a timely manner.

Treatment options for Lymphedema

Combined Decongestive Therapy (CDT) is the gold standard for managing Lymphedema in many countries.

CDT consists of following 4 components

  1. Manual Lymph Drainage (MLD); Gentle skin manipulation increases lymph flow and reduces swelling. MLD redirects lymphatic fluid to available lymph node groups when lymph vessels and/or nodes are blocked.
  2. Compression Therapy; For some cases, compression therapy (bandaging or garments) is used to maintain the limb size and further increase the effects of MLD.
  3. Exercise Regimen; Muscles and joints act as a pump to move lymphatic fluid, it is important to keep flexibility, muscle strength, and be active and mobile.
  4. Skin Care Regimen; Skin is a barrier against pathogens preventing them from invading your body therefor it is vital to keep the skin intact.

Treatment has 2 phases; intensive and maintenance. Intensive phase is used to reduce swelling as much as possible, and the maintenance phase is done less frequently with a goal of maintaining the outcome achieved in the intensive phase.

Neuroproprioceptive Taping (AKA Kinesio tape®, Elastic Tape®)

When specially made medical tape is applied in a specific manner over the swollen area, the tape lifts up the skin and opens venous and lymph capillaries. This process allows improved blood and lymph flow, which helps reduce swelling. This water resistant Neuroproprioceptive Tape can be worn roughly up to 7 days.

Lymphedema Treatment is a life-long commitment, it is important that patients knows the condition and how to manage and trouble-shoot, just like learning how to drive a car. The patient is in charge of setting the destination and practicing safe driving.

 

Akari Yokokawa is a registered massage therapist with a focus in lumph drainage and combined decongestive therapy.  She sees patients at Mahaya Forest Hill located at 73 Warren Road, close to St. Clair and Avenue Road.  For more information about Lymphedema and treatment options, email Akari at akariyokokawa@gmail.com, or visit www.careforlymph.com.