LYMPHEDEMA

Objectives Causes of lymphedema Phases of lymphedema Treatment of lymphedema Compression garments and bandages Other long term treatment options

Causes of Lymphedema Can Vary Some Examples Hereditary Surgical Removal of lymph nodes Damage to vessels Radiation Chronic Venous Insufficiency Some causes are unknown If surgery is the cause it may not appear for months or years later

Stages of Lymphedema Can vary as well as cause

Stage 1 Stage 1- Can be reversed Presents with soft pitting edema, little or no hardness of the tissue, and swelling. Usually goes away with elevation and rest

Stage 2 Stage 2-Is irreversible Swelling does not decrease with elevation, hardness of the tissues is present, strong pressure will produce pitting edema and extremity is hard

Stage 3 Stage 3- Is irreversible Considered elephantiasis with hardness of the tissue with skin papillomas

Treatment of Lymphedema Could consist of the following, but can vary person to person Initial evaluation Ongoing patient education Lymphatic Massage Skin care and hygiene Guidelines for the ADL Compression bandages Compression Garments Exercise instruction as needed Home Maintenance/Self care (long term)

Initial Evaluation Will include Medical History Pain discussion Problems patient has been experiencing Skin check Range of motion Strength Girth measurements

Education This will be completed throughout therapy sessions on how to manage your treatment at home in addition to education regarding your diagnosis

Lymphedema Bandages Bandages are designed to provide compression during movement Patients will need to purchase 2 sets of bandages so one can be washed, since they need to be worn 24/7 Bandages will be purchased by the patient with a cost starting at $150 depending on if we are treating an arm or leg, or if it is one side or both Once measurements reach a plateau you will be instructed in getting fitted for compression garments

Compression garments These garments can be off the shelf or custom depending on size and many insurance companies do not cover Compression garments are put on when you get up and taken off at bedtime This is one of your long term options when therapy is finished These garments start at $60 and increase whether it is for an arm or leg Arms will sometimes require a glove for swelling in the hand which typically is around $150

Other long term options Circ Aids are Velcro wraps that are used in place of bandages or compression stockings. These are more costly than stockings and sleeves/gloves and most insurance companies do not cover

Long term options continued Compression pumps are designed to act as massage but garments still need to be worn. Most insurances do not cover Compression garments are necessary to manage your lymphedema, without them your swelling will return

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