Lymphedema – Treatment & Plan of Care

We can help you overcome the symptoms of Lymphedema and provide that much needed relief that you’ve been seeking with a tailored plan of care including Complete Decongestive Therapy.

What is the Lymphatic system?

The Lymphatic system is made of vessels and nodes throughout our bodies from just below our skin to the deepest parts of our internal organs, in our brain, and along our blood vessels. The Lymph vessel’s main role is to help move fluid, proteins, and immune cells that accumulate around our tissues to return it to the circulatory system. This fluid in the tissues is called interstitial fluid, but once it enters the lymphatic vessels it is called Lymph.

Until recently, the venous system was thought to remove most of the interstitial fluid and lymph vessels only took up what was left including interstitial proteins. However, research with a substance called Indocyanin Green to visualize the uptake of interstitial fluid and studies on the properties of the endothelial glycocalyx (a system of protein chains that act as gates outside of cells) show that ALL of the interstitial fluid and proteins gets removed by the lymphatic system!

It also has a role in immune function as the lymph nodes that house immune cells and eliminate any bacteria or infectious organisms that would make us sick.

What is Lymphedema?

In the United States, lymphedema usually occurs as a result of treatments for cancer such as radiation, surgery, and chemotherapy that damages lymph vessels and nodes so they cannot take up interstitial fluid.

This damage is permanent as the Lymph nodes and vessels cannot repair themselves, so fluid continues to accumulate, making the affected body region swell gradually over time.

There are also certain genetic and hereditary conditions that can cause lymphedema, usually with onset in childhood or adolescence.

In the early stages of Lymphedema (stages 0-1), people may only notice a feeling of heaviness or tightness in the affected body region or swelling that goes away with elevating the limb or laying down.

In the later stages (Stages 2-3), the swelling does not go away and starts to cause changes in the skin making it more hard and rigid – a condition called fibrosis. This tissue rigidity and swelling leads to disfigurement and difficulty doing normal activities like walking or getting dressed.

What is CDT (Complete Decongestive Therapy)?

Complete Decongestive Therapy is the main treatment to manage lymphedema and prevent it from worsening. It includes 4 parts implemented in two phases. The 4 parts of CDT are:

• Skin care: proper bathing, moisturizing, and wound management are essential and can prevent serious, life-threatening complications such as cellulitis that can occur with lymphedema
• Manual Lymph Drainage (MLD) – a special type of massage that helps mobilize the interstitial fluid and lymph from areas where lymphatic vessels are damaged to areas where they are intact and working appropriately
• Compression bandaging – use of short-stretch bandages and compression garments to prevent accumulation of lymph and interstitial fluid and to also help re-direct the fluid from areas of lymphatic damage.
• Exercise – The lymphatic system pumps lymph in response to muscle pumping/flexing, diaphragmatic breathing, and elevation in our heart rate.

During the intensive phase, therapists educate patients in all of these aspects while instructing how to incorporate them into their lives. Therapists will perform MLD, wrap the affected body region with compression bandages, and instruct in appropriate exercises that are tailored to each individual. Therapists will also give recommendations and take measurements for compression garments to be used during the maintenance phase.

During the maintenance phase, patients learn to manage their condition themselves, integrating all parts of CDT into their lives. Patients then have an opportunity to follow up periodically with a skilled physical therapist who can ensure they are managing their limb correctly and provide them with the support as needed. This may include resuming the intensive phase or designing a new plan that will best meet their needs.

Certified Lymphedema Therapist – Eryk Ocasio PT, DPT, CLT

South Valley Clinic

3900 Las Estancias Court S.W. Suite 102

Albuquerque, NM 87121

Phone (505) 207-2344