WHAT IS LYMPHEDEMA AND HOW DOES IT DEVELOP?In addition to blood vessels, the body also has lymphatic vessels. These vessels transport protein-rich tissue fluid (lymph) back to the vascular system. Lymphedema is an abnormal accumulation of lymphatic fluid resulting from an imbalance between production and drainage. This imbalance can have various causes.
A distinction is made between primary and secondary lymphedema.PRIMARY LYMPHEDEMASometimes lymphedema can be congenital. This is called primary lymphedema. From birth, fewer lymphatic vessels are present, which can cause swelling to develop over time. Sometimes, it only becomes apparent after an infection. In mild forms, lymphedema develops between the ages of 18 and 35. In more extensive forms, it can also be present from childhood. Congenital lymphedema can often be bilateral. Insufficient lymphatic vessels can also be present elsewhere in the body, for example, in the arms. Most forms of lymphedema are not hereditary, although a predisposition can often run in families. As a result, several people in some families may experience swelling that initially occurs during periods of heavy stress on the lymphatic system, such as pregnancy, strenuous exercise, summer, or the onset of obesity. In the early years, the swelling is often not recognized as such because it is still intermittent. Only later does the swelling become permanent.SECONDARY LYMPHEDEMASecondary lymphedema is defined as damage to the lymphatic vessels. This can occur, for example, during cancer surgery, where lymph nodes from the groin or abdomen must be removed. This inevitably damages the lymphatic vessels. This increases the risk of developing lymphedema in the legs. This risk increases if the operated areas also require radiation therapy. Lymphedema can develop years after surgery, so it remains important to focus on prevention. Lymphedema in the legs can also be caused by damage to the lymphatic vessels following thrombosis, persistent varicose veins, or previous infections (erysipelas). Once lymphedema develops, it does not go away on its own and can be very debilitating.COMPLAINTS OF LYMPHEDEMASymptoms that may arise from lymphedema include swelling, a feeling of tiredness and heaviness, pain or tingling, limitations in movement and/or limitations in daily functioning, skin abnormalities and infections.HOW DO YOU RECOGNIZE LYMPHEDEMA?Normally, the skin over the toes is slender and wrinkled. Because there is little to no fatty tissue, the skin can be easily lifted.
A characteristic swelling of the toes often constitutes an initial suspicion of lymphedema. If you pinch the skin between the first and second toes with your fingers, you should see a thin wrinkle. This is called Stemmer's test. Swelling can develop slowly in the legs. Initially, it is often only present in the evening or after strenuous activity. The toes may also be slightly swollen. This could very well be an early sign of lymphedema.TREATMENT OF LYMPHEDEMAThere are various treatment options for lymphedema of the leg, such as compression therapy, pressotherapy, lymph massage (ML therapy), exercise therapy, physiotherapy, podiatry, and several others.
Aftercare with an elastic stocking:
Compression with elastic stockings is important to increase the pressure in the tissues, which reduces edema. Therapeutic elastic stockings are essential for lymphedema treatment to maintain the size of the leg. Keeping the leg edema-free minimizes the risk of complications and prevents further development of lymphedema. It is important to always wear the therapeutic elastic stocking when you are on your feet. Irregular wearing of the stocking can increase the size of the leg, causing it to no longer fit and leading to renewed complaints due to worsening of the lymphedema. A stocking only works effectively if it has an optimal fit. Always have your stockings re-measured when you are given a new one. It is important to continue exercising regularly. Muscle movement will improve lymphatic drainage.
Some guidelines
: - Prevent wounds and infections on the arm and hand.
- Disinfect any wounds thoroughly with a disinfectant and apply a bandage.
- Pay attention to calluses, corns, or cracks.
- Maintain good hygiene and take good care of your skin.
- Avoid overexerting your legs by gradually increasing your activities.
- Find a balance between rest and exertion, but try to move normally. Light exercise is fine,
such as walking, cycling, or swimming.
- Be careful with hot water, hot showers, and sauna visits. Prolonged foot baths are also not recommended.TO ASKIf you have any questions, please feel free to ask your GP or the doctor treating you. Further information is also available on the website of the Drachten Lymphedema Working Group:
www.lymfoedeem.nl |
