Lymphedema treatment in your everyday life - Dr. Zatrok’s blog

Lymphedema treatment in your everyday life

The underlying causes of the lymphatic disease can be varied, the affected area and the severity of the symptoms can also vary, but the outcome is mostly the same: it will “accompany” you throughout your life. Treating lymphedema is not about going to hospital for a few days a year! You need to design your life to ensure that caring for your lymphedema gets a permanent place in it. If you don’t deal with it, it will make your life impossible over time. If you pay attention to exercise regularly, eating a healthy diet, and apply the symptomatic treatments, your lymphedema will cause you little trouble.

Treatment of lymphedema

Many people think that lymphedema can be fixed with a few days of hospital treatment, and that’s enough. They are wrong!
Of course, lymphedema treatment is directed by your doctor or lymphatic therapist (that is, you will be told which treatments to use). However, they cannot put the bandage on for you and you cannot make it to hospital several times a day for lymphatic drainage. You have to do these things yourself!

Lymphedema is a disease that worsens constantly and unstoppably. The goal of all treatment methods is to slow down, suppress the oedema formation, and to direct the fluid (that still accumulates despite all efforts) to the area with healthy circulation.

Two levels of lymphedema treatment

  1. The first level is MEDICAL TREATMENT, performed in an outpatient clinic or hospital ward that are specialized in the treatment of lymphedema. It is a short-term, intensive treatment, lasting for a few days, aimed at getting you out of the severe oedematous condition, quickly reducing the oedema, and discharging you home.
  2. The second level is HOME TREATMENT, otherwise known as, MAINTENANCE TREATMENT. The latter period covers the rest of the year, namely, approximately 360 days of it. Consequently, that is more important to you than hospital treatment. Your health depends on only one person —you! It is ONLY UP TO YOU, what condition you maintain and whether you can avoid hospital treatment by preventing further deterioration of your condition.

Why is oedema unstoppable?

Lymph is also produced in healthy people with every heartbeat. That is, as long as your heart continues to beat, lymph is also formed. Lymphedema occurs when the lymphatic system, responsible for collecting and returning the lymph to the circulation, does not perform its function properly. In this case, the lymph does not get back into the blood, so it accumulates in your limbs (or in other affected areas of your body).
As the lymph is constantly being formed in your body and its collection is weakened, thus reducing oedema means a daily activity.
If you treat it, the oedema will decrease. As soon as you stop the treatments, its recurrence already begins. It’s only a matter of time when excess lymph fluid becomes visible, perceptible again.

Lymphedema lifestyle

Therefore, the life of a person, like you, who suffers from lymphedema, revolves around his/her illness. Whatever you do can affect your complaints. So your daily activities are influenced by the disease-related tasks.
Now let’s see what these tasks actually are!
First, I mention the options by which you can slow down oedema formation or accelerate its emptying (back to the circulation).
But these will not solve your problem completely. However, if you pay attention to these as well, you will have to deal with a smaller problem.

Rest with your limbs elevated

You may have noticed that your oedema decreases by morning. The reason for this is that, in a lying position, the lymph simply “flows out” of your limbs, spreading throughout your body. As you stand up, it causes the lymph to move with gravity back into your feet and palms.
Take advantage of this! Lie down for 15-20 minutes during the day, with your limbs elevated.

Move, exercise regularly, and lead an active lifestyle!

The natural engine of lymphatic circulation is the rhythmic contraction of the muscles. The muscle function “pumps” back the lymph and venous blood from the limbs to the heart.
The lack of exercise in itself exacerbates the oedema.
Daily exercise is the most natural and cheapest way to reduce lymphedema.
I don’t mean competitive sports. Walking, Nordic-walking, cycling are excellent choices. The point is, by starting gradually, you should spend at least 50 to 60 minutes a day on sport activities.
Lymphedema gymnastics is also appropriate (but I think it is less effective). You can even do it in your living room.

Pay attention to your weight!

Obesity and lymphedema go hand in hand! Obesity increases lymph formation. There are more blood vessels in the fat tissues, which retain a lot of water, thus more lymph is formed.
You can also improve your symptoms by losing extra pounds.
Eat a balanced, healthy and varied diet!
Please, avoid consuming animal fats and proteins, if you can, quit completely. These increase the concentration of the lymph, which in turn further increases the formation of oedema. Fats and proteins deposited between the tissues aggravate the circulatory disorder.
Vegetables and fruits should make up the bulk of your diet.
However, no special diet fits for all lymphedema patients.

Some medications increase the formation of oedema

Some antihypertensive agents (calcium channel blockers), hormones (contraceptives), steroidal and non-steroidal anti-inflammatory drugs, antidiabetics enhance oedema formation.
Replace or leave “suspicious” agents. Ask your doctor for advice.

Warm weather increases the formation of oedema

Lymphedema flares up in the period from spring to autumn. The heat (and consequently increased body temperature) causes the blood vessels in the skin to dilate, so that more blood is received and passes through them, and this will generate more lymph.
Wear light, well-ventilated clothing. Avoid sunbathing, staying in a warm place.
Hot-water bath and pool baths, all forms of saunas, vacuum body treatments should be avoided.

Pay close attention to skin care!

Oedematous and tight skin is vulnerable, and shows little tendency to heal due to its poor circulation. Protect your feet from all injuries, insect bites and wounds. Pay special attention to nail care.
Application of lymphedema wraps, toe wraps, is excellent for this purpose. Its role in reducing oedema is minimal. Its purpose is to protect vulnerable skin folds between the fingers/toes, and prevent the formation of injuries, sores. In the case of lymphorrhoea (defined as ‘leaking of lymph fluid through the skin’) and ulcers, bandages are also required to protect the wounds and prevent infections.

However, those listed only contribute to treatments aimed at reducing oedemas.

Treatment of lymphedema

Lymphedema wrapping (bandaging)

It is recommended for those who do relatively little exercise.
Use a low-elasticity bandage, and place a foam sponge pressure distribution underlay under it. Compression of the limb quickly drives out the oedema fluid, so it loosens the soft tissues, and the oedema with it, and breaks down the lymph. You need to take it off again and put it back on again.
The hands and feet should be wrapped tighter than the upper parts of the limbs, which makes it easier for the lymph to move upwards.
From an obese, chunky thigh, the bandage falls off quickly, it creases in the hollow of the knee and cuts in the soft tissues. Adjust it! Unwind the bandage and put it back on properly.

Elastic pressure stockings / gloves

These are recommended for those who exercise a lot because they amplify the oedema-reducing effect of muscle movements.
They are less tight than the bandages / dressings, but more flexible. Correct application of the bandage is not easy, especially for the obese and disabled. Ask your relative for help.
ALWAYS use elastic stockings when exercising. Exercising in compression stockings is much more effective, than exercise alone or just wearing the stockings.

Manual lymphatic drainage

This is a massage technique with gentle movements, intended by the therapist to smooth, guide the oedema towards a body area with intact circulation.
Manual lymphatic drainage was developed in the 1930s. There is no convincing evidence that it would be effective. Nevertheless, it is widely used because it is a “tradition” as this technique has been applied for a hundred years. Although, its validity is increasingly being questioned.
It is unaffordable for the majority of people when carried out properly, applying the required number of treatment sessions. Another problem is that the treatment is never given when he/she needs it most, but when the masseur has time and welcomes the patient.

Electrotherapeutic Lymphatic Drainage (Electro-Lymphatic Drainage)

Muscle contractions induced by electrical impulses, similar to walking (the most natural motor of lymphatic circulation), improve circulation and reduce oedema.
Muscle stimulators are less expensive than pressotherapy devices and can help reduce swelling in all severity forms of lymphedema.

Mechanical lymphatic drainage (pneumatic compression)

Studies have shown that it is the most effective method for reducing oedema. It acts through compression. Muscle stimulator machines are less expensive than lymphatic massage machines and can help reduce swelling in all forms of lymphedema. It “squeezes” the lymph out of the tissues, lymphatic vessels, and even the venous blood from the veins. If the air compartments of the cuff are inflated one after the other (from bottom up), then both lymph and venous blood are directed upward towards the intact area.
Mechanical lymphatic drainage supports the arterial, venous, as well as the lymphatic circulation, and reduces the risk of thrombosis. Slowly but surely, it will take the place of other existing methods in the field of home / maintenance treatment.

Self-lymphatic drainage

It is a type of lymphatic drainage that can be performed by the patient, the technique and movements of which can be mastered with a few hours of practice.
Self-treatment of the arms can be done by everyone. However, treatment of lymphedema in the legs / lower limbs is more excellent for the thin, flexible, and mobile people! Stout, obese people with limited mobility are usually unable to perform it because they cannot bend down to their own legs.

Summary

When treating lymphedema, use as many methods as possible at once. You can depend crucially on yourself and your relatives regarding the treatment. Methods and tools are available for everyone who is willing to take action to improve the quality of his/her life.

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