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Treatment of Problems

Lymphedema patients are constantly frustrated, as they clearly face a major problem, yet cannot find answers to reduce a swollen limb. The most frequently given advise to elevate the limb, wear and elastic sleeve or stocking, avoid salt and take diuretics. Sequential pumps are sometimes recommended and while they may give some relief, the benefits are short lived. Surgery has never solved the problems of Lymphedema, even though dozens of different operations have been recommended and thousands of patients have been operated on Dr. Vodder’s Combined Decongestive Therapy offers a practical and long lasting solution to the millions of lymphedema sufferers throughout the country.

What is the Treatment of Lymphedema?

Lymphedema is a serious condition, indicating that the lymph system is unable to handle the lymph load. Treatment should begin as soon as lymphedema is diagnosed.

The goal of treatment is to reduce swelling and facilitate the flow of the lymph fluid to the venous circulation of the affected area.

The most effective approach used by therapists in many European countries is Combined Decongestive Therapy; a four step process, carried out over a 4 week period. The individual elements are Manual Lymph Drainage, compression therapy, remedial exercises, breathing techniques and excellent skin hygiene. The patient visits the clinic once or twice a day, 5 times a week, or in accordance with the physician’s recommendations.

Complex Decongestive Therapy

  1. Massage Therapy Patients receive Manual Lymph Drainage (MLD) once or twice a day to remove excess fluid and protein. The MLD is performed to open lymphatics in the unaffected regions so these can help to drain the affected area. MLD stimulates the lymphangions to increase their activity, which results in a decompression and emptying of obstructed lymphatic channels.
  2. Compression Therapy Bandaging of the affected limb follows each MLD session. This is a precise and accurate procedure using specific bandages and interfacing materials.
  3. Remedial Exercises and Breathing Further promote venous and lymphatic flow by activating the muscle and joint pumps.
  4. Skin Care and Hygiene Excellent skin cleansing with antibacterial washes and neutral balanced pH lotions will help to eliminate the possibility of repeated attacks of cellulite and/or lymphangitis.

Manual Lymphatic Drainage (MLD)

Developed in Europe in the 1930’s by Dr. Emil and Estrid Vodder, Manual Lymph Drainage (MLD) is a safe, effective, yet gentle approach to cleansing the body’s tissues. MLD drains excess fluid from the tissues and also has a detoxifying effect. It can benefit a healthy person as well as be applied to more than 60 different conditions.

Scientific studies, as well as vast clinical experience, have supported the effectiveness of MLD.

The therapeutic benefits of MLD, evidenced by more than 30 years of research, are well documented. It is widely prescribed by physicians in the United States and Canada also recognize the benefits of MLD for their patients.

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What is Lymphedema?

Lymphedema is a swelling of a body part, most often an extremity, resulting from an accumulation of fluids, in such proportion to be palpable and visible. Lymphedema occurs when the lymph vascular system is not able to fill its function of reabsorbtion and transport of the protein and lymph load. Lymphedema occurs whenever lymphatic vessels are absent, underdeveloped or obstructed.

The condition most often causes embarrassment and causes decreased mobility, discomfort and often repeated episodes of infection, cellulitus and lymphangitis. This can lead to general depression and a general worsening of the patient’s life and health. Fungal infections can be very frequent and these place a greater load on the lymphatics. Severe cases are associated with thickening of the skin, hardening of the limb (fibrosis), leakage of lymph and massive swelling (elephantiasis).

How Does Lymphedema Occur?

A stagnation of protein develops in the tissue. This raises the colloid osmotic pressure and a protein rich edema arises. There are more protein rich fluids in the tissue than can be transported and the proteins attract water by osmosis. The affected area becomes swollen, enlarged and uncomfortable. This swelling decreases oxygenation of the tissues, interferes with their normal functioning and makes them heal more slowly than normal. The excess protein also serves as a stimulus from chronic infection and can result in formation of excess fibrous tissue. Lymphedema is a chronic and if left untreated, progressive condition. It can however, be brought under control by appropriate treatment and care.

Lymphedema may be due to a primary (congenital) cause or of a secondary cause (caused by a known condition), including removal of the lymph nodes or trauma.

Primary Lymphedema

Primary Lymphedema is that which has no known cause. Milroy’s disease is a familial (genetically caused) lymphedema which is present at birth. Meige’s disease is similar, but appears no later than puberty.

Lymphedema Praecox is the most common form of primary lymphedema. This begins in adolescence. It is predominantly females who suffer from this condition. Seventy five percent of primary lymphedema is praecox.

Lymphedema Tarda is identical to Lymphedema praecox but occurs after the patient is 35 years old. Both praecox and tarda almost always involve just the legs.

The pathological mechanisms which cause primary lymphedema are an absence of lymphatics (aplasia), inadequate lymphatic drainage, too few lymphatics or too few nodes, or lymphatics which are hugely dilated.

Secondary Lymphedema

Secondary lymphedema is an acquired condition resulting from loss or obstruction or previously normal lymphatic channels. The most common cause of secondary lymphedema is due to removal of the lymph nodes, as part of surgery for malignancies. The lymph pathways can be interrupted by radiation, surgery, injury or blockage with parasites. Trauma or radiation can tear a major lymph trunk or cause the production of excess fibrous tissue, which later constricts the lymph vessel.

Lymphedema may also occur as a result of a chronic venous disease, which always involves the large lymphatic vessels that run beside the veins.

Lipedema

Lipedema is a condition of an excessive amount of fat deposited in the leg and buttocks combined with changes in the lymph vessels. In the early stages, the foot remains normal and fat deposition occurs from the ankle to the buttocks. The lymphatics are either abnormal, or become affected by this as lipedema progresses. Venous insufficiency and lymphedema may start to appear as well.

Benefits of Manual Lymph Drainage

  1. MLD removes metabolic wastes, excess water, toxins, bacteria, large protein molecules and foreign substances from the tissues.
  2. MLD, through its gentle rhythmical precise hand movements, alleviates pain by greatly reducing the pain signals sent to the brain.
  3. MLD relaxes the sympathetic nervous system, thus helping to relieve stress.
  4. MLD supports and enhances the actions of the immune system
  5. MLD helps the body to heal more quickly from injuries, surgical trauma, chronic conditions, and edema.

Treatment indications

Surgical

  • Post-Mastectomy Edema
  • Post-Hysterectomy Edema
  • Varicose Veins
  • Post-Surgical Swelling
  • Pre-Surgery Preparation
  • Post-Surgery Recovery
  • Pre/post Cosmetic Surgery
  • Post-Amputation
  • Post-Vein Stripping
  • Lymphedema Strains/Strains
  • Muscle/Ligament tears
  • Fractures/Dislocations
  • Rheumatoid Arthritis
  • Tendinitis
  • Neck Pain/Whiplash
  • Chronic Pain

Musculoskeletal

  • Strains/Strains
  • Muscle/Ligament tears
  • Fractures/Dislocations
  • Rheumatoid Arthritis
  • Tendinitis
  • Neck Pain/Whiplash
  • Chronic Pain

Ear, Nose & Throat

  • Allergies
  • Hay Fever
  • Sinusitis
  • Tinnitus
  • Neuralgia, RSD

Neurological

  • Tension Headaches
  • Migranines
  • Neuralgia, RSD
  • Multiple Sclerosis
  • Parkinson's Disease
  • Carpal Tunnel Syndrome
  • Stress Reduction
  • Migranines
  • Carpal Tunnel Syndrome
  • Parkinson's Disease
  • Multiple Sclerosis
  • Tension Headaches
  • Meniere's Disease

Dermatological

  • Acne/eczema
  • Leg ulcers
  • Burns/scars
  • Neuralgia, RSD

Other

  • Fibromyalgia
  • Chronic Fatigue
  • Toxic Poisoning
  • Scleraderma
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