What is lymphoedema?
Your guide to defining, diagnosing and explaining lymphoedema.
A description of lymphoedema symptoms of the arms and legs.
Lymphoedema is a swelling of the body that in most cases has a slow onset. It may start as a persistent ache or shooting pains in an affected limb. Sometimes it may start as a pain in the shoulders before swelling becomes visibly apparent.
In the first instance lymphoedema swelling may resolve or disappear overnight with rest. Over time the oedema becomes a more permanent fixture and disruptive to your lifestyle.
Not all oedema is caused by lymphoedema. It is best that your doctor performs tests to eliminate all other possible causes of fluid retention before making a diagnosis.
Lymphoedema indications
An explanation of indications to help diagnosis – a list of
lymphoedema symptoms.
You may experience some or all of these
conditions.
Lymphoedema can occur in any person when their lymphatic system is compromised. For some people this will be after a surgical procedure or trauma after an accident. With others it may be their lymphatic system is not developed sufficiently to be effective for their body size.
| INDICATIONS – Hints to diagnosis of leg and lower body lymphoedema | |||
| Feet & Ankles |
Lower
Leg |
Thighs and Hips | Shoulders and Neck |
|
Swollen toes Fat ankles Increased swelling later in the day Painful toes, feet or ankles |
Swollen calves Discoloured skin Hot legs Ulceration and/or weeping skin |
Swollen thighs Aching or pain at top of legs in groin. Swelling or Hot and/or tender to touch in groin Restless legs Distended tummy |
Swollen neck Swelling below collar bone Increased swelling later in the day Dull ache and/or shooting pains Feeling of fluid inside chest area when breathing. |
| INDICATIONS – Hints to diagnosis of arm and upper body lymphoedema | |||
|
Hands & Wrists |
Forearms and Elbows |
Upper arms and Chest |
Neck, Chest and Shoulders |
|
Swollen fingers Cracked dry skin |
Swollen forearms Swollen elbows Shooting pains |
Swollen upper arm Weeping skin Swelling and/or pain in the chest tissues |
Swollen neck Swollen back Swollen chest Feeling of fluid inside chest when breathing Skin discolouration Shooting pains |
A review of family history can help lymphoedema diagnosis:
When you require an explanation for swelling, a good diagnostic guide for the possibility of lymphoedema can be made by examining your family history.
In many cases a grandparent or aunt may exhibit signs of lymphoedema swelling, yet your direct parent may not. This observation can provide insight and guidance by association when making a valued judgement and lymphoedema diagnosis.
A explanation and review of medical tests for lymphoedema.
The tests used for lymphoedema diagnosis;
There are
four tests used with lymphoedema diagnosis
Lymphoscintigraphy; –a radio active substance is injected at the most distal part of an affected limb, its progress is traced with a gamma camera to see if progress is normal, slow or blocked.
Computed tomography; - (CT Scan) shows cross section images of tissues or a MRI Scan is used where malignancy may be suspected.
Duplex imaging study; - Ultrasound to identify/rule out chronic venous insufficiency which may cause similar symptoms to lymphoedema.
Bioimpedence analysis (BIA); - an extremely small electrical current measures the amount of resistance in body tissues. This can ascertain the possibility of lymphoedema before any visible signs of onset.
Why a deficient lymphatic system causes lymphoedema.
An explanation and answers to why and how a deficient lymphatic system causes lymphoedema.
Lymphoedema swelling is caused when localised plasma proteins leaked from arterial blood capillary walls remain trapped in the body’s soft tissues long term due to irreversible dysfunctional lymphatic drainage and consequential macrophage (large scavenger cells) overload. These systems are the only two natural methods of protein removal from the soft tissues of your body.
All lymphoedemas have this common problem regardless of what caused the dysfunctional lymphatic condition to occur.
Why do trapped proteins in the tissues cause such a problem?
Proteins can be likened to a magnet and its magnetic field, for just as a magnet will draw iron filings around itself within its magnetic field; similarly (plasma) proteins will draw body fluids to themselves, not by a magnetic field, but by the action of osmosis.
Too greater a concentration of proteins (than that of approximately 2% of extra cellular body fluids in the body tissues) in any one area will cause too much fluid retention and consequential oedema, or lymphoedema, if the entrapment of excess protein is permanent.
Therefore it could be said:
Lymphoedema is directly caused by; ‘ The protein deposit into tissues from arterial blood capillary walls being greater than protein transport out of tissues by the lymphatic sytem, over a prolonged period of time’.
Diagnosis of lymphoedema in the arms or legs following cancer treatment.
Lymphoedema after cancer.
After cancer treatment in many cases the lymphatic system is disrupted and will not perform its full function for removing protein from the body tissue fluids as described above. This lymphatic dysfunction, if severe enough, may cause the condition of lymphoedema.
Lymphoedema of the arms. The diagnosis of lymphoedema after the initial swelling from breast cancer surgery has subsided, in many cases is first indicated by a feeling of heaviness of the arm on the affected side and/or pain in the neck and/or shoulders.
Swelling and oedema may never happen, or it may take many months or even years before any symptoms are encountered to become apparent in a limb at risk after your surgery.
Lymphoedema of the legs is affected by surgical and radiotherapy intervention to the area of the groin and in the pelvic region, and sometimes by surgical intervention of the lymphatic system in the region of the neck.
A heaviness of leg or legs is often a sign of probability to lymphoedema onset after cancer surgery. As with lymphoedema of the arms, swelling may never happen or take months or years to become apparent. Tests for the legs, are as for the arm in the early and later stages.
Bio-impedance testing for lymphoedema is a good indicator of the likelihood for lymphoedema activity after cancer surgical intervention. Early diagnosis is beneficial where your surgical intervention had a probability of affecting lymph nodes or the lymphatic drainage system. Ask at your cancer clinic, they often have bio-impedance testing equipment available.
Radiation therapy and lymphoedema. Results of trials monitoring cancer survivors indicate a greater chance and incidence of lymphoedema occurrence when radiation therapy is administered additional to surgical intervention.
Who is at risk after cancer therapy? After surgical intervention and a combination radiation therapy after surgery you have an increased risk of developing lymphoedema. This knowledge can be to your advantage if you take pro-active and preventative action by incorporation of lymphoedema risk minimisation strategies into your daily routines.
Medical reviews and statistics prove lymphoedema after cancer is by no means a certainty. Not everyone develops lymphedema after cancer intervention. By taking a little care and implementing action at the slightest positive indication, you can minimise your risks of developing lymphoedema exponentially.
Lymphoedema symptoms occuring after cancer treatment can be controlled, managed and reversed. Knowledge and action are your keys to success.
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