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June 24, 2009 > Help and Hope for People with Lymphedema

Help and Hope for People with Lymphedema

The prevalence of lymphedema is difficult to determine because many cases are never diagnosed. According to the U.S. Department of Health and Human Services, however, an estimated 3 million Americans suffer from this progressive and often debilitating condition.

"Lymphedema is very much under-reported," says Tina Hammond, a lymphedema therapist at the Washington Hospital Lymphedema Clinic. "Many physicians and other medical professionals are not familiar with the problem. And, even when the condition is diagnosed properly, patients are often told that nothing can be done."

There is hope for lymphedema sufferers, though. Washington Hospital is one of a handful of health care providers in the San Francisco Bay Area that provides specialized treatment of lymphedema that can help patients manage their disease and lead more normal lives.


Causes and Symptoms

The lymphatic system plays a crucial role in the body's immune system. Lymph - a clear, watery fluid containing white blood cells that recognize and remove foreign substances such as bacteria and protein wastes - circulates throughout the body via the lymphatic system. In lymphedema, the lymph fluid accumulates in part of the body and causes swelling, most often in the arms or legs, but occasionally in other parts of the body such as the head, neck, torso or genitals.

"There are two basic types of lymphedema," says Hammond, who is certified as a lymphedema therapist by the Lymphology Association of North America (LANA). "Primary lymphedema is when a person is born with a deficient lymphatic system - even though the symptoms may not show up until later in life.

"Secondary lymphedema can be caused by removal of or damage to the lymph system as a result of surgery, radiation, infection or trauma," she continues. "For example, women with breast cancer who have their lymph nodes removed during a mastectomy could be at risk for developing secondary lymphedema. Men who have surgery or radiation for prostate cancer can develop lymphedema in their lower extremities. Lymphedema can happen immediately after surgery, radiation or chemotherapy treatment for cancer, but it also can show up years later."


Treatment

Early treatment of lymphedema is essential, and patients must manage their condition throughout their lifetimes. Prior to intensive treatment, patients would need to follow their physician's instructions for treating any infections with antibiotics first. Treatments provided by the Lymphedema Clinic might include:
* Instructions for daily skin care to ensure there are no breaks in the skin.
* Manual lymph drainage massage to redirect the lymph fluid back up to the heart where it is pumped to the kidneys to filter out wastes.
* Applying compression bandages or garments around the affected extremities to prevent fluid from re-collecting.
* Therapeutic exercises to help move the lymph fluid throughout the body.
* Information about proper diet and nutrition to support the immune system, since obesity and diabetes can both increase the risk of lymphedema and jeopardize the effectiveness of treatment.

"The sooner we begin treatment after the onset of lymphedema the better the outcome," Hammond notes. "There are some situations where we would not start massage, compression and exercises right away, though. First, if there is an active infection present, we would wait until the infection responds to antibiotics. We also would delay treatment in cases where the patient has untreated congestive heart failure. Patients also need to be cleared for blood clots, which is another contraindication to our treatment."


Importance of Education

"We offer extensive patient education, since our goal is to teach patients to manage the condition themselves," Hammond says. "In addition, we offer educational services to medical professionals to increase awareness of lymphedema. We also encourage physicians to refer breast cancer patients to us prior to any surgery so that we can teach the patients how to prevent lymphedema."

Hammond cautions lymphedema patients to check the credentials of therapists offering lymphedema treatments. "Unfortunately, there is no standardized national required level of training for people providing lymphedema treatment," she explains. "Certification through LANA assures that the therapist has the proper training."

To obtain treatment through the Washington Hospital Lymphedema Clinic, patients must first get a referral from their physician and then call (510) 795-2058 to schedule an appointment. They also may need authorization from their insurance company before treatment begins.


Lymphedema Education Class

Washington Hospital offers a Lymphedema Education Class to anyone who is interested in learning more about the lymph system and lymphedema. The class covers general information about the anatomy and function of the lymph system. The class takes place the second and fourth Tuesday every month from 3 to 5 p.m. in the Washington Women's Center Conference Room located at 2500 Mowry Avenue (Washington West) in Fremont.

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