Lymphedema Q&A

Lymphedema: Your Questions Answered

How did I get edema or swelling in my hands or feet?  A lack of physical activity, diet, and venous insufficiency or venous dysfunction from degeneration can result in increased movement of fluid from blood vessels into the tissue spaces. Edema is caused by the increased fluid in these spaces. Normal fluid exchange is maintained by a balance between your blood pressure, gravity, and proteins in your tissues. If this fluid remains too long it creates lymphatic compromise.

My doctor told me I have venous insufficiency; what does that mean? It means your blood flow through the veins is inadequate, causing accumulation of fluid through your extremities. This chronic long-term fluid accumulation results in tissue edema and is often associated with lymphedema.

What is Lymphedema? Lymphedema results from lymphatic system disruption. It is a chronic condition of abnormal fluid accumulation. This is when protein-rich fluid accumulates in soft tissue spaces and fails to flow normally into the lymph vessels. Lymphedema can be Primary (inherited) or Secondary (acquired).  Lymph vessels help to transport excess fluid accumulation. Your lymphatic vessels return about 2-3 liters of fluid per day back into the bloodstream.

What symptoms do most people get with Lymphedema? Signs and symptoms can include: Swelling, Cramping during the day and especially at night, Restless legs symptoms, Pitting Edema, Pain, Achiness, Heaviness, Weakness, Decreased ROM, Ulcers, Loss of Balance, and Infection.

Do diuretics help with Lymphedema? Unfortunately, diuretics have no value for the treatment of lymphedema in patients who do not have edema due to some form of congestive heart failure. Lymphedema is a high protein edema that is not eliminated from the use of diuretics. Decreasing the pressure in the venous system by removing water from the venous system does not help reduce lymphatic swelling. Please consult with your doctor to determine if taking a diuretic is right for your diagnosis before starting or stopping.

Does flying put me at an increased risk of Lymphedema? Yes, normal flight cabin pressure is around 8,000ft of elevation. This decreasing pressure change causes a decrease in fluid movement resulting in increased lymphatic symptoms.

Is there a cure for Lymphedema? Unfortunately, there is no cure. Treatments for lymphedema associated with chronic venous insufficiency. are aimed at controlling symptoms, maintenance, and education. Conventional management is currently the most successful approach. Please remember to keep up with a treatment program as prescribed by your PT daily once treatment concludes for maintenance of symptoms.

Why do I need strong calf muscles? Muscle contraction of the calves provides a milking action that acts to propel venous flow and lymphatic fluid. Valves in each of these vessels prevent back-flow of fluid. Previously under-appreciated, the calf muscle pump can help significantly reduce venous and lymphatic accumulation.

My doctor gave me a compression garment what should I do with it, and why should I use it? Compression garments are effective for providing relief of varicose veins, spider veins, tired legs, aching legs, swelling of the feet, ankles, and lymphedema. With the loss of skin elasticity the muscle pump loses its normal counter-pressure.  Adding compression garments can improve muscle pump effectiveness. Proper fit of these garments is essential. They should be replaced frequently, as they will stretch over time.

Can I use ace-wrap to help for the swelling? No, ace-wrap is a long stretch bandage that applies too much pressure and can collapse the superficial lymph vessels. Please avoid using these during lymphatic treatment.

What can I expect during my Physical Therapy treatment? You can usually expect treatment to include Intermittent Pneumatic Compression Pump, Assisted Lymphatic Drainage, Calf Muscle Pump Exercises, Compression Garments, and Video Gait Analysis. This combination of treatments is called Complex Decongestive Therapy.

Did you work with my physician to create a treatment plan? Yes, we work closely with your physician to create a protocol that is safe, effective, and clinically supported. We are striving to bring you the best possible outcome of decreasing swelling and pain, while increasing functionality and strength.

How good is your protocol? We are on the cutting edge of current lymphedema research and have worked extensively with Mission Cardiac and Vein Center to develop a state-of-the-art treatment plan. This program has a 92% success rate, and was chosen to present at the College of Phlebology’s National Meeting in Nov of 2016.