Lymphedema Pumps and Indications for Use

  What is Lymphedema?

Lymphedema is a condition whereby the lymph fluid accumulates in the tissue or in the cavities of the body. Lymphedema normally takes place due to a blockage of some type that impedes the normal flow of lymphatic fluids. Lymphedema may be categorized in two ways, primary and secondary lymphedema.

The reasons for primary lymphedema are quite often unknown since there is no proven and specific etiology in most cases. The causative agents in secondary lymphedema can be multiple and diverse. It may be caused by removal of lymph channels by a specific disease process, or by a defect which was present at birth.

Without treatment, lymphedema can cause multiple other problems that must be resolved. Lymphedema can be problematic, often creating open areas or ulcerations on the body, or may preclude walking well due to swelling of the affected parts. Treatment is indicated when the swelling reaches a point that is causes discomfort or undesirably affects the body in some way, or as a preventive measure to preclude those effects.

What are Your Treatment Options for Lymphedema?

Treatment of lymphedema may take many forms. It can include compression hose, may require bandaging, or other means of compression. Medications may be used to help you to manage your lymphedema. It may even, in some very rare cases, be treated surgically.

The typical treatment will begin with oral medications, in combination with compression garments that will sometimes be effective in managing less severe cases of lymphedema. If those measures are not successful, more aggressive treatment of the condition will become necessary.

Most often, the treatment for lymphedema when other, lesser measures have failed will be the use of a lymphedema pump.

How Do Lymphedema Pumps Work?

Lymphedema can be managed quite well in many cases by the use of lymphedema pumps. They use as a methodology, the compression of the affected area. This is done by compressed air which is piped into a device which fits over the affected area. The rationale for the treatment is to push the edema into the more central area of the body where it may be uptaken by the lymph system.

In most cases, the device which is used on the body, known as a cuff, will be shaped as the arm or leg. Compressed air enters the cuff and puts pressure on the area. The compressed air may be used in one or two ways, depending on the device. In some lymphedema pumps, the pressure is constant and standard in every area on which the cuff lies. In other varieties of lymphedema pumps, the pressure on the affected area will be intermittent.

Are All Lymphedema Pumps the Same?

Individual pumps will offer different optional items such as design of cuff, as well as pressure available for use from the pump.

Once you have achieved some relief from the use of the lymphedema pump, most physicians recommend that you maintain that by the use of a compression garment.

Exercise Guidelines for Lymphedema Survivors

When I was diagnosed with lymphedema in 1997, the standard advice was to "baby" my swollen arm. Exercise was limited: anything weighing more than three pounds had to be carried with my other arm. I would feel lopsided as I lugged a gallon jug of milk with my normal right arm. And I hadn't heard of medical problems such as muscle atrophy and frozen shoulder.

Last year a study was conducted at the Abramson Cancer Center of the University of Pennsylvania by an exercise physiologist to determine whether a slowly progressive program of strength-training exercises is safe for breast cancer survivors with and without symptoms of lymphedema. ("Weight Lifting in Women with Breast-Cancer-Related Lymphedema," the New England Journal of Medicine ( August 13, 2009) by Kathryn Schmitz, PhD, MPH.

According to Dr. Schmitz,"This problem(lymphedema) affects up to one-half of the nearly two million breast-cancer survivors alive in the U.S. today - which means that there may be as many as one million women who suffer from some form of lymphedema...Further, the psychological effects are enormous...Indeed, many women have reported that they would rather have another mastectomy than lymphedema - because it's a painful, constant, and debilitating reminder of their breast cancer."

Why should you exercise? Because it is beneficial for people in general (weight loss, feeling of well-being, health benefits, etc.). For those with lymphedema, muscle exercise increases the lymph flow rate multiple times over the resting rate. In addition, exercise is a key element of Complete Congestive Therapy (CDT), the gold-standard treatment of lymphedema, because it helps drain lymph fluid from the swollen limb and into the circulation.

But before you begin any exercise program, check with your therapist or physician. Build your strength up gradually, exercise in a controlled manner, and stop if you experience any pain. Be sure to drink adequate amounts of water, warm up before the activity and cool down afterward, wear your compression garment on your affected limb, and opt for loose clothing. Many therapists also advise that you perform deep abdominal breathing before and after exercise to stimulate lymph flow.

Aerobic exercise is a great way to stay fit when you have lymphedema. Any way you increase the circulation helps. While there are many ways to do it (biking, jogging, and walking), I particularly recommend swimming, which is a great overall endurance exercise that uses water as part of the compression.I joined a club with an indoor pool just to get the year-round benefits that swimming offers. Activities that used to be taboo when I was diagnosed are now allowed, such as golf, tennis, and triathlons if done using the precautions noted above and approved by your therapist. And one activity that had been advised for lymphedema patients in 1997, a mini-trampoline, is now no longer recommended due to the risk of injury.

Resistance training-once frowned upon for lymphedema survivors-is now considered beneficial, thanks to Dr. Schmitz's study noted above. It requires that muscles exert a force against some form of resistance. Dr. Schmitz's study specifically found good results when these strength-training exercises were part of a slowly progressive program. I purchased a set of dumbbells with progressive weights (5, 10, 15, 20, and 25 pounds) that I use to increase my arm strength in a gradual, controlled manner as now recommended. And bench pressing can be beneficial if done properly. Again, it is best to consult your therapist on the proper technique to use.

Stretching exercises, including yoga and pilates, are another way to improve the symptoms of lymphedema, when combined with the other activities noted in this article. Stretching moves the skin, muscle and other tissues in the affected lymph and relieves the feeling of tightness that patients often experience in their affected arm or leg. Range of motion, flexibility and freedom of movement of the lymphedemous limb are also improved by stretching. My therapist taught me active elongation exercises on a stability ball to help to stretch scars to increase flow of lymph fluid to the bloodstream.

Please note that Dr. Schmidt mentions six misconceptions about her exercise study on the National Lymphedema Network Web site:

1. Misconception: Weight training prevents lymphedema. Short answer: The study did not address prevention of lymphedema.

2. Misconception: If weight lifting is safe, and all those years we told women not to weight-lift, then all those other cautions like avoiding blood pressure or blood draws on the affected side must be wrong, too. Short answer: When lymph nodes are damaged or removed, many risk reduction guidelines still apply to avoid infection, inflammation, injury and trauma.

3. Misconception: The study results mean that all women with lymphedema can buy weights or a gym membership and do what they want without fear of their lymphedema getting worse. Short answer: This study was done in a controlled and supervised way with precautions.

4. Misconception: If I do weight-lifting, I will never have another flare-up of lymphedema. Short answer: Lymphedema can flare up if safety guidelines in the study are not followed.

5. Misconception: If it is safe for me to do weight-lifting, then it is okay for me to lift heavy things at work or at home. My boss can ask me to lift heavy things at work now because the trial results show it is safe for me to do so. Short answer: Some of the women in the study never progressed beyond 5-pound dumbbells.

6. Misconception: The trial results mean it is safe for those with lower extremity lymphedema to do weight-lifting, too. Short answer: The results are inconclusive, so they cannot be extrapolated to leg lymphedema.

Please note that this information does not replace the advice of a qualified health care professional.

A retired patent attorney, Jan Hasak authored a memoir, "Mourning Has Broken: Reflections on Surviving Cancer." In this work she shares how her hope in Christ sustained her as she underwent breast-cancer treatment at ages 43 and 52, and dealt with lymphedema.

Her second book, "The Pebble Path: Returning Home from a Forest of Shadows," takes a poetic look at her cancer journey, relating the story of a princess who picks up pebbles of wisdom while traveling down the path following her cancer diagnosis.

Ms. Hasak is listed on the National Cancer Survivor Day Speaker's Bureau roster and is an American Cancer Society volunteer and a patient-advocate for the National Lymphedema Network (NLN). She received a Lymphedema D-Day Award for her service to the lymphedema community.


Popular posts from this blog

What Can Real Estate Agents Do For You?

A Deeper Insight Into The Benefits Of Online Shopping