What is Lymphedema?

In your case, lymphedema is a protein rich fluid that accumulates in the interstitum (space between the muscle and the skin) of the legs and feet. Lymphedema is a chronic and progressive condition. If left untreated, you may be susceptible to recurrent infections, chronic ulcerations, severe pain, drop foot (inability to pick up your foot) and in extreme cases amputation.

What causes Lymphedema?

Lymphedema is a pathological condition involving the veins in the leg. The damaged venous system is unable to effectively return blood back to the heart during standing or walking. As a consequence, the fluid in the veins moves into the superficial veins (causing varicose veins) and down towards the feet causing edema. Damaged veins can be caused by an acute deep venous thrombosis (DVT) that does not heal properly, varicosis and/or abnormal development of venous valves.

What stage is my lymphedema and what will the treatment consist of?

Stage 0
1. No edema present. Your lymphatic is able to compensate for minor damage to the veins.
2. No treatment indicated.

Stage I
1. Edema or swelling appears in the later part of the day, usually in the ankles and disappears over night.
2. Treatment - Compression therapy, elevation and exercises. Without treatment your condition will eventually progress to Stage II.
** Please note that diuretics may prolong the development of Stage I. Unfortunately, diuretics can actually lead to the progression of lymphedema and should not be used as a replacement for compression therapy.

Stage II
1. Persistent edema that spreads into the middle of the lower leg. May have small hemorrhages on the skin that initially appear as red spots, which will later turn brown. Other skin changes may start to occur, ie. dryness, bacterial infections, inflammatory changes and small breaks in the skin.
2. Treatment - Complete decongestive therapy is a must or you will eventually develop ulcerations.

Stage III
1. Ulcerations develop. Approximately 85% of ulcerations are related to venous pathology and they are predominantly found on the inside of the lower leg and will only sufficiently heal if the area is free of edema.
2. Treatment - Complete decongestive therapy and wound care.

What is compression therapy?

After edema develops, the skin loses its elastic memory and does not provide resistance to the underlying tissue. Compressive bandages or garments provide resistance to the tissue to improve the efficiency of the muscle pump force required for venous return, shift the fluid into the center of the body, prevents back flow of the veins and disperses the edema to allow an increase in the reabsorptive surface.

Special short stretch bandages and compression garments must be applied and fit by specially trained personnel. These bandages are usually applied in conjunction with manual lymphatic drainage. There are many classes and grades of compression garments and they should only be applied and fit when your leg is not swollen.

What is Complete Decongestive Therapy (CDT)?

In my office, CDT is administered by special trained personnel. It is a combination of manual lymphatic drainage (MLD), compression therapy, decongestive exercises and skin and nail care. MLD is a gentle manual treatment technique that increases the activity of the lymph vascular system. Wounds are dealt with on an individual basis and in conjuction with your physicians orders.

Treatment, complete decongestive therapy, may take anywhere from 2 weeks to months depending on the chronicity of your condition.

We accept most insurance companies.

Please call our office for more information and verification of benefits for your insurance.