TMH Living Well: New lymphedema treatment program at hospital
June 26, 2015
If you've been diagnosed with cancer, you're mostly focused on the next step in the treatment process. You want to get the tumor removed then receive needed treatments to keep it at bay. The aftereffects of treatment are not the first thing on anyone's mind. Yet many people survive cancer and look forward to picking up where they left off before the disease, but there are often unexpected symptoms that arise such as lymphedema. Living with lymphedema — swelling, usually in your arms or legs — is not pleasant.
"If you've been diagnosed with cancer or are in the process of receiving treatments for cancer, ask your doctor about how you can be aware of risk factors, signs and symptoms of lymphedema," said Danika Friedley, PT, DPT, CLT, and lymphedema specialist with The Memorial Hospital's Cancer Rehab Services.
According to the Mayo Clinic, lymphedema is most commonly caused by the removal of lymph nodes during cancer treatment — a customary practice to stage cancer. It can also be caused by direct damage to lymph nodes due to radiation treatment. Lymphedema is one of the most common side effects of breast cancer treatment.
It's important to know your risks before getting cancer procedures done. If a single node can be biopsied rather than taking several nodes, that's ideal. If radiation can be targeted to prevent damage to the lymph system, that's also smart. It may not prevent lymphedema, but it can decrease your chances.
"Once you have lymphedema, it can't be cured. You'll have to manage it the rest of your life — and it will progress if left untreated. However, with lymphedema therapy the effects of lymphedema can be greatly reduced," Friedley said.
Our lymphatic system is part of our immune system. It runs throughout our body like our blood vessels. Key areas have many lymph nodes, including our necks, under our arms and in our groin areas. When the system is impaired or damaged, lymph can't flow properly and fluid gets backed up. The result is swollen, uncomfortable limbs that feel heavy with fluid and may ache. Without treatment, swelling becomes extreme and risk for skin problems and infections increase.
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"Our lymph system is essentially a large drainage system. When functioning normally, it pumps itself and is rhythmic and consistent, but when it's impaired it needs help, and that's where lymphedema therapy comes in," Friedley said.
Relief comes in the form of therapy — the most effective treatment is known as CDT or complete digestive therapy.
"CDT has three components: manual lymphatic drainage, which redirects lymph flow and moves the fluid for reabsorption; compression bandaging to decongest the area; and lastly, wearing a compression garment to keep the swelling under control," Friedley said.
Getting treatments as soon as possible from a certified — rather than simply informed — therapist is important. TMH is dedicated to providing the gold standard of lymphedema treatment. While weekend courses for lymphedema training are common, the hospital sent Friedley for full certification — an intensive, 10-day, hands-on certification through the renowned, research-based Klose Training organization that is associated with the Foeldi Clinic of Germany.
"Not many hospitals will go to the expense to send a therapist to become certified in lymphedema treatment. They invested in me, but even more so, they invested in the community. They really want to offer the best care they can to cancer survivors and others who cope with lymphedema," Friedley said.
Besides cancer, there are a few other diseases that cause lymphedema, plus some that mimic it. Friedley can help patients determine the cause of their swelling.
"Chronic heart failure and chronic venous insufficiency can also cause swelling that resembles lymphedema. If you have swelling, it's important to get it checked out," she added.
Friedley is happy to offer the new service for Craig and surrounding areas, which patients have had to travel for in the past. If you have noticed swelling in your limbs or even other areas after cancer treatment, ask for a referral for physical therapy from your doctor.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig – improving the quality of life for the communities we serve through patient-centered healthcare and service excellence.