Lymphedema develops when
the lymph system is unable to remove the
lymph fluid from an area of the body,
and the protein rich lymph fluid is left
behind to accumulate in the tissues, and
this stagnant tissue causes damage. It’s
not “just swelling”.
The lymphatic system is a
crucial, yet poorly studied, entire body
system of lymph nodes and collecting
tubes that captures the protein rich
fluid that leaves our arteries and veins
and is a crucial component of our immune
system. You can see an illustration of
it here:
http://www.sasklymph.ca/lymph_diagram_wide.php
Although the lymphatic
system runs nearby the blood vessels,
unlike our circulatory system, it
doesn’t have a heart to pump the fluid
and it relies on the actions of our
surrounding muscles and some
contractions of the lymph vessels to
move this important lymph fluid back
into the circulatory system. The lymph
system is in “quadrants”: right and left
upper quadrants and right and left lower
quadrants and each has pathways back to
our venous system. It’s a fragile
system, nearly impossible to see and
easy to damage. Lymphatics run
throughout our intestines and along our
bones as well.
Edema is swelling, and
“lymphedema” is swelling due to excess
lymphatic fluid. But, it’s not so simple.
·
Lymphedema can exist
without obvious swelling, but the
tissue is still being damaged by the
inflammation caused by the fluid.
Often, before there is swelling,
there are symptoms of
heaviness, tingling,
warmth, numbness and/or pain.
·
Over time, extra
lymph fluid in the tissue causes
changes in the skin, the
“subcutaneous tissues,” with extra
fat being deposited and fibrosis
(hardening) of the tissues.
Lumphatic
fluid is part of the body’s immune
system so a damaged lymphatic system,
with lymphedema, both decreases the
body’s protective defenses and is prone
to infection.
The
lymphatic system can be damaged by
surgery, radiation, chemotherapy or
trauma. Some people have lymphatic
systems that are genetically predisposed
to fail. They may have a condition
called “primary lymphedema”, which can
occur at birth or later in life, or they
may more easily acquire lymphedema after
damage to the lymphatic system—called
“secondary lymphedema”.
Most people who get
lymphedema after cancer treatments
develop it within three years of
treatment, but the risk is life-long.
Our lymphatic system is also prone to
aging, so the onset can be at any point
after the damage has occurred. There can
be triggering events that overwhelm a
fragile system: infection, overuse,
extreme heat, air travel, medical
trauma—such as IV’s, injections or
excess pressure on the body.
Unfortunately, there’s
no single agreed upon scientific
definition of lymphedema, so it’s a
“clinical” diagnosis. It’s important to
look at the whole picture: not just size
and volume measurements, but the
appearance of the limb or other body
part. As Andrea Cheville, MD of Mayo
Clinic has written:
"There
is no one value or standard you can
use to say, ‘OK, if you meet that
you have lymphedema, and if you
don’t, well then you don’t have
it,’” says Dr. Cheville. “For
example, there may be no size or
volume changes in the arm, but you
could have subtle hand swelling or
pitting on the arm. So it’s
important not to be too locked into
arm measurements alone, as that can
create a false sense of security.
You also need to be watching the arm
and looking for the loss of what we
call ‘anatomic architecture’ — an
inability to see the veins and
tendons in the arm as clearly, or
less pronounced knuckles, or skin
that is less wrinkled and therefore
looks younger.”
http://www.breastcancer.org/treatment/lymphedema/evaluation/diagnosis
Lymphedema is defined as
stages:
·
Stage 0: Latent
lymphedema: an at risk-area that may
have excess tissue but no lingering
swelling
·
Stage 1: swelling
that pits—indents
when pushed, but can be reduced with
treatment
·
Stage 2: swelling
that persists, even with treatment,
causing the skin to harden
·
Stage 3: advanced
swelling with extensive tissue
changes, some changes irreversible
Please look at these
images of hand and arm lymphedema:
http://www.stepup-speakout.org/What_does_lymphedema_look_like.htm
Page Last Modified
11/17/2014
