Lymphedema: 6 Things You Need to Know

1. What is lymphedema?

Lymphedema is mainly swelling that appears on the limbs. Its cause is the accumulation of lymph (fluid) in the space between cells.

Initially, the swelling is mild. To the touch, it feels like yeast dough. If you press it with your finger, it retains the imprint, leaving a small pit that doesn't even out for minutes. By morning, it decreases or almost completely disappears because when lying down, the fluid “flows” to an area where your lymphatic system is intact and is absorbed.

If left untreated, your condition will worsen. The swelling grows, you experience a tight, aching pain. Your skin cracks and straw-yellow lymph oozes out. Proteins deposit between cells, the edematous area hardens and can no longer be indented with your finger. The skin begins to flake, wart-like growths appear, and the area discolors reddish-purple.

2. How does lymphedema develop?

Even a healthy person produces lymph!

Your blood circulation consists of three parts.

1. Your arteries carry fresh blood throughout your body to the cells.
2. Your veins collect most of this blood and transport it back to your heart.
3. What your veins cannot "collect" is left to the lymphatic system.

As long as you are healthy, the blood brought by the arteries is returned to circulation by your veins and lymphatic vessels together, preventing swelling from developing.

Lymphedema occurs when your lymphatic system becomes diseased or damaged and cannot fulfill its "transport" role. What it fails to remove accumulates relentlessly between tissues.

If your veins are also diseased (dilated, twisted, with slowed flow), along with malfunctioning lymphatic vessels, even more burden falls on the lymphatic system. Mixed venous and lymphatic lymphedema has more severe symptoms.

3. What causes lymphedema?

In poor regions of Africa and India, infections are still the main cause of the disease. The pathogens enter the body through contaminated drinking water and damage the lymphatic vessels.

In wealthy countries, including ours, infection-related lymphedema is rare. Here, two main types are known.

Congenital

• Usually develops in women, rarely appearing in childhood; symptoms more often begin in adolescence or during the first pregnancy.

Acquired

• This form is much more common, accounting for at least 65–70% of domestic cases.
• Most commonly occurs due to surgery, accidents, or injuries.
• Appears on the arm after most breast cancer surgeries.
• Also common a few years after varicose vein surgery, liposuction, hernia operations, gynecological, urological, or major abdominal surgeries.
• Can occur after accidents involving multiple fractures.
• More frequent in obese individuals because fatty tissue is filled with vessels producing more lymph. The lymphatic system, designed for a smaller body, cannot collect the extra lymph produced by the enlarged body.

4. Is lymphedema curable?

Currently, lymphedema is not curable but it is TREATABLE.

The goal of treatment is to reduce the swelling back to normal size so you can live a normal life, while preventing worsening of the condition.

If you have lymphedema, you must learn the treatment from your doctor or nurse. You need to understand the necessary steps and take care of it yourself daily. If you don't, you harm yourself!

Hospitals, clinics, masseurs, nurses, and doctors are never available exactly when you need them. You have to schedule appointments and wait. But YOU are always "on hand"!

5. How is lymphedema treated?

As mentioned, lymph is produced anew with every heartbeat. This means that once you stop treatment, lymph begins to accumulate again.

Therefore, consistent treatment is required. Symptoms of "true" lymphedema need to be managed daily, at most every two days!

It is important to know: diuretics have no effect on lymphedema, but they weaken you. Do not take diuretics for lymphedema—they won’t help!

Home treatment consists of several parts.

Direct edema-reducing methods

Bandaging:
Advantage: helps if you move little.
Disadvantage: slips easily during movement, digs into creases, must be rewound and reapplied. Thin individuals can put it on easily; with slight overweight, it is almost impossible to apply.

Elastic (compression) stockings:
Advantage: supports muscle pumping during movement.
Disadvantage: not easy to put on or take off, especially with overweight.

Self-lymphatic drainage massage.
Advantage: With some learning and practice, effective because you can help yourself anytime.
Disadvantage: Most overweight people cannot reach their own leg.

Therapist-performed manual lymphatic drainage.
Advantage: Excellent if done frequently enough.
Disadvantage: Availability and cost.
You do not get appointments when you need them, but when the therapist is available.
A treatment costs about 10,000 HUF. Visiting twice a week isn't effective. Frequent treatments are expensive, possibly costing millions yearly.

Machine lymphatic drainage (compression therapy unit).
Disadvantage: not as precise as a trained lymphatic massage therapist.
Advantage: You can buy a medical-certified compression therapy unit (with leg cuff set) starting at 140,000 HUF (Power Q-1000 Plus).
A professional unit (Power Q-1000 Premium) costs about 240,000 HUF.
You buy once and it serves 8–10 years. You take it out when you need it.

Indirect edema-reducing methods

Contribute to reducing and suppressing edema formation.

• Rest with limbs elevated, 10–15 minutes during the day.
• Regular exercise (Nordic walking, cycling are most effective).
• Watch your weight! Obesity and lymphedema go hand in hand!
• Eat a varied diet! Reduce consumption of animal fats and proteins.
• Some (medicinal) drugs increase edema. Avoid these.
• Heat enhances edema formation. Avoid sunbathing and hot baths.
• Pay attention to skin care. Edematous skin is fragile. Protect your legs from injury, insect bites, and wounds. Pay special attention to nail care.

6. What should you do to improve?

Due to lack of proper information, most Hungarian lymphedema patients believe that annually prescribed 5 (sometimes 10) days of hospital treatment is sufficient. Is this true?

NOT AT ALL!

As I already mentioned, your lymph disease accompanies you from its onset throughout your life! The edema reproduces with every heartbeat, meaning you cannot skip a single day, let alone 360. However, social health insurance currently only treats you for a few days, leaving you alone for the remaining 360 days.

You must realize that you can only count on yourself; how much you suffer from symptoms depends solely on you.

If you manage it, you suffer little; if you ignore it, it will make your life miserable. And, of course, your family's life will also be affected because untreated you will eventually need help from them.

My advice: take care of your lymphedema treatment on a daily basis; make it part of your everyday routine. It will repay the daily 20–30 minutes invested!