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Lymphedema Can Cause Arms and Legs to Swell

February 19, 2013

Washington Hospital Offers Services to Keep the Chronic Condition Under Control

You may not think much about it, but your lymph system plays a critical role in protecting the body from infection and disease. Every day the body produces about two liters of lymph fluid that travels through an intricate network of vessels just below the skin. When that system doesn't work right, the fluid backs up, causing the arms and/or legs to swell. This fluid can even ooze through the pores of the skin.

"I like to compare the lymph system to a waste management system," said Tina Hammond, a lymphedema therapist at Washington Hospital. "Every cell in the body produces waste and that waste has to get out of the body."

The lymph system is made up of tiny, thin tubes called vessels that carry the nutrient-rich lymph fluid. The vessels travel through a web of nodes that store white blood cells and filter bacteria and waste. Lymph fluid helps the body fight infection and then it drains to other parts of the body, Hammond explained.

The lymph fluid eventually collects near the neck and then flows into two large ducts. These ducts empty into vessels under the collarbones, which carry the lymph fluid to the heart, where it is returned to the bloodstream.

Lymph fluid must keep moving through the body for the lymph system to work properly. But when part of this system is damaged or blocked, fluid can't drain from body tissue and it backs up, causing swelling.

"A common cause of lymphedema is cancer treatment, but you can also be born with it," Hammond said. "When the lymph nodes are radiated or removed to treat cancer, it damages the lymph system and can keep it from working properly."

Primary lymphedema can be present at birth or develop at the onset of puberty or in adulthood, and has no known cause, although it can be hereditary, she added. Secondary lymphedema, or acquired lymphedema, can develop as a result of surgery, radiation, infection, or trauma. Hammond said it is often linked with breast and prostate cancer treatments.
Proper Management is Critical

"There is no cure for lymphedema or even medication that can reduce the symptoms," Hammond said. "It is a lifelong condition that has to be managed. We try to give people the tools they need to keep it under control on their own. Self-care is a critical component of living with lymphedema."

She teaches patients how to care for the condition and control the symptoms, and works with them to develop an effective treatment plan. Treatment includes manual lymph drainage massage, compression, skin care, exercise, and diet.

Unlike traditional massage, which uses forceful pressure that can increase swelling, lymphatic massage uses gentle strokes to stimulate the area just below the skin. Hammond is specially trained to perform this type of massage, which helps to move lymph fluid out of the swollen area and into an area with working lymph nodes and vessels, or where it can be drained. Patients can be taught to do this type of massage therapy themselves, she added.

A compression garment that is worn on the arms and/or legs can also be effective. It applies pressure in gradients, which helps to move the fluid through the lymph vessels and prevent it from building up.

Good skin care is important because people with lymphedema are susceptible to infections of the skin and nails. The protein-rich lymph fluid is an ideal nutrient source for bacteria and other pathogens, she explained. The inflammation that occurs with an infection can cause swelling.

Exercise can help the lymph vessels move the fluid out of the affected limb and decrease swelling, although people with lymphedema need to be careful because exercise can also increase inflammation, Hammond said. A diet that helps to reduce inflammation can also be beneficial, she added.

Anyone who wants to learn more about managing their lymphedema can attend Washington Hospital's free Lymphedema Education Series that Hammond teaches. It is held the first and third Mondays of the month, from 1 to 2:30 p.m., in the Women's Center Conference Room, located at 2500 Mowry Avenue (Washington West) in Fremont.

"Lymphedema can affect quality of life, so it's important to know how to manage it," she added. "It can be very disabling if not treated properly."

For more information about Lymphedema Services at Washington Hospital, call (510) 795-2058 or visit www.whhs.com/cancer/lymphedema.