Our body consists of many systems and various parts connected to these systems. Each of these systems is involved in vital functions and works continuously throughout our lives. There are arteries (arteries), veins (veins) and lymphatic vessels in our body. The lymphatic system continues its task by the presence of lymph vessels, lymph capillaries, lymph cells, lymph nodes, tonsils, thymus gland and spleen in a liquid environment. This fluid contains oxygen and nutrients necessary for cells.
After the cells take the substances they need, they leave the waste materials to this environment. These wastes are carried in the lymph fluid and after filtering in the lymph nodes, they enter the circulation as clean lymph fluid. Therefore, the lymphatic system; Working with the immune system, it plays a role as a protective filter in body defense.
What is Lymphedema ?
Lymphedema is a condition characterized by abnormal accumulation of protein-rich fluid and persistent swelling of the extremity, resulting from lymphatic dysfunction. This disorder can be congenital or acquired.
Although many systems have been proposed for the classification and staging of lymphedema, there is no accepted system that covers the cause of the disease, its mechanism of formation and the patient’s condition.
If the lymphedema is classified according to the causes;
If the lymphedema is classified according to the causes;
- Primary causes: Congenital, as a result of underdevelopment of lymph vessels in the womb, any trauma, infection or compression forces are among the primary causes of lymphedema.
- Secondary causes: The lymphatic system of the person has been functioning normally since birth, and subsequent surgical operations, tumoral disorders following the vessels, and applications such as radiotherapy may cause lymphedema.
Lymphedema swelling usually occurs in one or both arms or legs, depending on the extent and localization of the damage. Primary lymphedema can occur on one or both sides of the body. Lymphedema can cause an extremity to swell up to several times its normal size. It may be first noticed by the affected person as an asymmetry between both arms and legs, or difficulty fitting into clothing or jewelry. If swelling becomes prominent, it may present with fatigue from the added weight, discomfort, and limitation of daily activities. The affected areas may feel tender and painful, and a loss of mobility or flexibility may occur.
Local and general symptoms of lymphedema ;
- Regional swelling , feeling of fullness
- ROM limitation
- Regional increase due to swelling.
· Skin irritation , rashes , allergic reactions
· A feeling of discomfort when a person is moving and an inability to control his weight
· Usually, these patients consist of obese people.
After taking the necessary anamnesis from the patient, the diagnosis is made through medical imaging techniques. The patient is then referred to a physical therapist. In the treatment of lymphedema, the specialist doctor applies the complex unloading physiotherapy method together with the physiotherapist.
This treatment consists of 5 different methods:
· Manual lymph drainage (The lymph system is manually manipulated and the lymph fluid with congestion is transferred to other lymph nodes. Physiotherapists with classical massage training should not perform this treatment. The necessary procedure should be carried out by healthcare professionals who have worked in the field of lymphedema and have received their expertise)
· Compression (it is provided with bandages and stockings. These stockings should be made specially for each patient. These stockings are used during the treatment period. ) Wrapping your entire limb encourages lymph fluid to flow back into your body. The bandage should be tightest around your fingers or toes and should loosen as you move your arm or leg up.
· Skin care (Moisturizers should be used twice a day. The pH level and application directions of these moisturizers are important. Care should be taken that the patient’s skin is not dry)
· Exercise ( Preventive exercises are strictly recommended, since there is no drug treatment for lymphedema . Exercises can be made difficult according to one’s fatigue , tolerability. )Light exercises in which you move your affected limb can promote lymph fluid drainage and help you prepare for daily tasks. Exercises should not be tiring muscle focus on gentle contraction of the muscles of the arm or leg.
· Pressure Pumps (Recommended under the control of a doctor or physiotherapist)
The Effect of the Disease on the Patient and Daily Life
Lymphedema is a disease that usually occurs in the limbs. It has been observed that this disease is also encountered after surgical operations, apart from environmental factors. After the post-operative period, patients have problems adapting to daily life. To give specific information, the incidence of lymphedema after breast surgery, especially in female patients, is 25%. Lymphedema generally occurs after breast, prostate and lower abdomen cancers. These problems are listed as psychological traumas experienced due to the inability of the person to perform work and social life, the inability to receive the necessary treatment – because there is insufficient specialization in this field – the lack of sufficient mobility and the chronicity of the disease.
What Should We Do To Avoid Lymphedema?
·Let’s keep our skin clean, let’s do the necessary cleaning with water, lotion, handkerchiefs
· Let’s use pure moisturizers. Moisturizers with alcohol, perfume and powder clog our skin, keep it dry and make it difficult for the skin to breathe.
·Let’s not scratch our swollen arm with our nails, let’s scratch it with our palms.
·Let’s prevent infection of cuts and open wounds on the skin. Let’s do the necessary cleaning and bandaging with antibacterial products.
· Let’s use a machine while cleaning the genitals, armpits or other areas. Products such as wax and razor are disadvantageous in terms of application and results.
·Let’s stay away from foods and external factors that cause allergies to our body.
· Let’s make optimum use of sunlight. Extra sunlight causes dryness on the skin.
· The clothes and accessories we wear should not be in such a way as to squeeze our body . The more clothes, the better!
· Let’s not keep our limbs motionless for a long time. (Especially those working at desk jobs should follow this rule!)
· Let’s not carry too much weight in our exercises or in our daily life. Let’s avoid sudden movements and extreme joint games.
· BE SURE TO GO TO OUR DOCTOR FOR ANY SWELLING WE ENCOUNTER IN OUR BODY.
- Lymphedema Treatment, Toktaş H., Çevik H., Dündar Ü., Güleç Ö. , Kocatepe Medical Journal Kocatepe Medical Journal 16:269-272/October/2015
- What is lymphedema and how is it treated? , Associate Professor Sibel Eyigör Ege University Faculty of Medicine Department of Physiotherapy and Rehabilitation
- Written resources of the Anatolian Lymphedema Society site
- Lymphedema , Gürsoy A. , Erdöl H., Okuyan M. , Journal of Atatürk University School of Nursing Vol: 9 Issue: 4 2006