Today is World Lymphedema Day. And if you’re not sure what it is exactly, it will come as no surprise to you that the people who suffer from it are underserved, according to one local specialist.
In light of the way the lymphedema affects many people around the world, we decided to sit down with Flo Capone, a licensed massage therapist here in Gainesville, who also happens to be a certified lymphedema therapist.
What is it?
Lymphedema affects the lymphatic system, part of the circulatory and immune system in the body. It occurs because there’s a breakdown in the system that prevents the vessels from transporting fluid. This breakdown results in a buildup of protein-rich fluid.
“The most common cause is from breast cancer surger with the removal of one or more lymph nodes.” It’s this “insult” to the lymph system that lays the foundation for lymphedema.
With pathways your body is accustomed to having for draining lymphatic fluid suddenly gone, the system can break down in that area of your body. Swelling may occur soon after the procedure or it could take years to present itself.
What Can Be Done?
Individuals diagnosed with lymphedema have a long road ahead of them. “It’s a lifelong condition,” Capone said. “It doesn’t get better if you ignore it. In fact, it gets worse.”
Surgical intervention to treat lymphedema continues to emerge. For example, skilled microsurgeons are now performing procedures where healthy veins in the swollen area are connected to the lymphatic vessels—a process called anastomosis—to promote drainage. But this option is extremely limited at the present time.
Instead, Capone suggested, people with lymphedema should make a lifelong commitment to managing the condition, starting with complete decongestive therapy.
Complete Decongestive Therapy and Manual Lymphatic Drainage
Following diagnosis, a physical therapist or occupational therapist will perform an assessment and begin complete decongestive therapy which consists of exercises, skin care, compression, and manual lymphatic drainage, a technique that Capone spent many hours training in.
The technique is not a deep tissue massage. “Most of the lymphatic vessels are just beneath the skin,” Capone explained. “I use a skin stretching technique to activate them and get the fluid moving better.”
Of course, not every patient is ready for this treatment.
“Sometimes, there’s fibrosis. So I start with myofascial release,” Capone explained. The fibrosis occurs because of the presence of proteins in the lymphatic fluid. When physicians prescribe diuretics, like Lasix, to reduce the fluid buildup, water is removed but the proteins remain. With enough protein in the area, the tissue begins to fibrose, or harden. Once the fascia is loosened, her treatment of manual lymphatic drainage can begin.
Capone said there are other ways to help alleviate your symptoms if you have lymphedema. One of them is movement. “Unlike the cardiovascular circulatory system, which has the heart to promote the flow of fluid,” she clarified, “the lymphatic system depends on muscle movement and activity.” She also encourages patients to stay active by walking or playing pickleball or simply moving the affected limb while seated. Activities done in water are even better. “The hydrostatic pressure combined with muscular movement helps decrease swelling.”
Can a Certified Lymphedema Therapist help someone with lymphedema? Yes. But Capone stresses that the patient has to do their part. “People have to take care of themselves.” That includes self manual lymph drainage, wearing your compression garments, exercising and taking care of your skin.