Lymphedema Treatments?

My mother-in-law was recently diagnosed with Lymphedema after ovarian cancer treatments, hysterectomy and chemotherapy. Needless to say she is very depressed. I know there is no cure but I wanted to learn about treatments that could help her.

Treatment

The treatment of choice for lymphedema is Complete Decongestive Therapy (CDT). CDT consists of manual lymphatic drainage (MLD), short stretch compression bandaging, therapeutic exercise, and skin care. MLD was pioneered by Dr. Emil Vodder in the 1930s for the treatment of chronic sinusitis and other immune disorders, and is now recognized as a primary tool in Lymphedema management. Therapists can today receive certification through special classes conducted by various organizations specializing in MLD.

The MLD component of treatment consists of gentle, rhythmic massaging of the skin to stimulate the lymph nodes to open and drain. The treatment is very comfortable and nonaggressive. A typical session will involve drainage of the neck, abdomen, trunk, and involved extremity and lasts approximately 40 to 60 minutes, depending on the severity and extent of the lymphedema.

Compression bandaging is the application of several layers of compression garments to the involved area(s), which includes one or more short-stretch bandages. Short-stretch bandages are preferred over long-stretch bandages (such as Ace(r) bandages), as the long-stretch bandages cannot produce the higher tension necessary to safely reduce Lymphedema. The bandages are in most cases comfortable for wear during sleep and rest, unlike Ace(r) wraps which can become very tight and cause cutoff of blood circulation without regular body movements. During activity, the short-stretch bandages provide increased resistance against the affected areas and, therefore, help to soften fluid-swollen areas as the muscles push out during exercise and daily activities.

Therapeutic exercise while compression bandaging is worn is used to help improve lymphatic flow. Also, some patients with chronic Lymphedema or large, swollen areas will have poor strength or range of movement. These patients benefit from exercise prescribed specifically for them by their therapist to help improve their function and comfort.

Skin care is an important component of CDT. People with Lymphedema or who have had lymph nodes removed are at a higher risk for infections of the affected areas. Teaching higher risk sufferers about the signs and symptoms of infections is key to early identification and treatment. Untreated infections can further damage an already impaired lymphatic system and lead to more severe Lymphedema and skin ulcers.

Initially, CDT involves frequent visits to a certified therapist with a doctor's prescription. Once the Lymphedema is reduced, increased patient participation is required for ongoing care, along with the use of compression garments to further reduce the swelling.

Compression pumps are sometimes used in the treatment of Lymphedema, but special care needs to be taken to ensure that the involved trunk quadrant is properly treated with manual lymphatic drainage before the application of a compression pump. If adequate treatment of the trunk is not carried out, the edema may be pushed into the upper portion of the arm or leg, or into the genitals. If a patient's Lymphedema worsens during a course of compression pump therapy, reassessment for adequate trunk MLD is necessary.

A new adjunct treatment is being taught to therapists utilizing a special type of tape called Kinesio Taping [1]. It is used to help soften edemas.
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Sources

* "Lymphology: An Emerging Field of U.S. Medicine" - Annual Conference 2006 Kansas City, October http://www.lymphology.org
* Lymphedema Diagnosis & Treatment, LLTretbar, MD and BB Lee, MD: Springer Verlag 2006
* National Lymphedema Network | "What is Lymphedema?"
* Schingale, Franz-Josef, "Lymphoedema, Lipoedema, Diagnosis and Therapy: A Guide for Those Affected," 2003, Hannover: Schl眉tersche GmbH & Co. KG.