1. LYMPHEDEMA

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

3. 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

4. Stages of Lymphedema
Can vary as well as cause

5. 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

6. 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

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

8. 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)

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

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

11. 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

14. 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

16. 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

17. 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

18. Any Questions?