What is lymphedema?

Lymphedema is a buildup of fluid within the tissues. This typically develops due to poor circulation of lymphatic fluid out of the affected area. The same amount of fluid continues to be produced but with slower transportation the fluid gets backed up in the tissues.

How is lymphedema diagnosed?

Lymphedema is diagnosed clinically meaning that your physician will diagnose you based on your signs, symptoms, and history. There are tests which can help us visualize your lymphatics, but none are recognized as diagnostic.

What kinds of lymphedema are there?

There are two types of lymphedema: Primary and Secondary. Primary lymphedema is caused by a genetic or hereditary issue with the formation and/or function of your lymphatics. Depending on the underlying issue, lymphedema can be present at birth, or not show up until puberty or even later in life. Secondary lymphedema is caused by a known trauma to the lymphatic system. This can include surgery or removal of lymph nodes, radiation, or even traumatic accidents with significant injury to the soft tissues. Most commonly in the world, secondary lymphedema is caused by a parasite. In the US the most common cause of secondary lymphedema is breast cancer treatment.

What is the lymphatic system?

The lymphatic system is a series of pipes and valves similar to the venous system. The lymphatic fluid leaks out of the blood vessels in order to survey all the cells in the body. The fluid picks up dirt, debris, bacteria, and other harmful cells. This fluid then is collected and transported through the lymphatic channels until it reaches a lymph node. The lymph nodes have an important role of surveying all the fluid to determine if any harmful cells or bacteria were picked up. If bacteria is detected then the lymph nodes send white blood cells back to the area to help fight it off. If the fluid appears clean, then it continues to travel all the way through the lymphatic channels until it reaches one of two large pipes up near the neck that dump the lymphatic fluid back into the blood stream to circulate around the body again.

Is there a cure for lymphedema?

There is currently no cure for lymphedema. Through conservative maintenance with CDT and the addition of our microsurgeries we are able to help patients get a better hold on managing it and slowing down the progression.

Can lymphedema be prevented?

Surgical oncologists are now performing less and less full lymph node dissections by testing and only removing the sentinel nodes thus reducing the risk of lymphedema significantly. However, the higher risk of lymphedema remains for those patients undergoing a lymph node dissection. Newer studies out of Italy show promise that a prophylactic bypass performed at the time of lymph node dissection can reduce the risk of lymphedema by 10 times. However, there are no known preventative measures that reduce the risk to 0 once the injury or insult to the lymphatics has been done.

How long will lymphedema symptoms last?

While some patients are able to detect their lymphedema early and seemingly have resolution, most patients have lymphedema that continually progresses and end up with a lifelong diagnosis.

What is a lymphedema Center of Excellence?

A lymphedema Center of Excellence is a group of medical professionals from various areas of medicine with additional skills, training, and expertise in managing and treating lymphedema. They are able to work together using the most recent studies and their own experience to treat and manage lymphedema in the most effective way to achieve the best results possible.

Who are the experts in lymphedema diagnosis and treatment?

Dr. Skoracki, Dr. Dean, and Karen Hock, PT as well as multiple Physician Assistants, Nurse Practitioners, and Physical Therapists that are housed within the center.

What are the treatment options for lymphedema?

Traditional conservative treatment for lymphedema includes CDT performed by PT or OT. This includes learning self care, self drainage massage, range of motion activities, and bandaging. Once the affected area is no longer decreasing in size with bandages a compression garment is worn to continue to maintain the results.

Advances in surgery to include microsurgery (surgery done under a microscope) and a renewed interest in lymphedema has broadened the treatment options available. A lymphovenous bypass is a microsurgery in which a lymphatic channel that is still functional is connected to a nearby vein in order to allow the venous system to transport the lymphatic fluid out of the area. A vascularized lymph node transfer is a microsurgery in which a flap of tissue is harvested from inside the abdomen which contains many lymph nodes and is reconnected to a blood supply in the area affected with lymphedema. This is performed in patients without functional lymphatic channels remaining. These surgical options are not cures for lymphedema but are simply additional ways to help relieve some of the symptoms of lymphedema and slow the progression.

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