Living with Lymphedema

During surgery for breast cancer, the doctor might remove one or more lymph nodes from the underarm area to see if the cancer has spread. When lymph nodes are removed, lymph vessels that carry fluid from the arm to the rest of the body are also removed because they route through and are wrapped around the nodes. This removal of lymph nodes and vessels changes the flow of lymph fluid in that side of the upper body. This makes it harder for fluid in the chest, breast, and arm to flow out of these areas. If the remaining lymph vessels cannot drain enough fluid from these areas, the excess fluid builds up and causes swelling, or a condition formally known as lymphedema.
“Lymphedema can result due to the absence of properly functioning lymph vessels or nodes or the inability of the lymphatic system to remove sufficient waste. It may be caused by infection, cancer or scar tissue formation and can be affected by treatments such as surgery, chemotherapy or radiation therapy,” explains Parker, OTR/L, CLT-LANA.
This gradual build-up of lymph fluid in the fatty tissues under the skin usually develops slowly over time. However, the resulting swelling can range from mild to severe. It can start soon after surgery or radiation treatment or begin months or even many years later.
This condition’s detrimental effects on an affected patient can manifest both physically and emotionally.
“Lymphedema can have a significant impact on all aspects of a patient’s life,” explains Tammy Parker of Cape Regional Medical Center’s Outpatient PT Unit.
“It can cause decreased movement of the affected arm or leg and a decrease in the ability to care for one self or what we call ‘daily living’. It can cause a feeling of heaviness or weakness and can cause pain and affect the fitting of clothing and/or shoes, all of which can have an impact on a patient’s self-esteem,” continues Parker.
Once lymphedema has started, it cannot be cured. But early and careful management can reduce symptoms and help keep it from getting worse.
Cape Regional Medical Center’s Outpatient-Based Rehabilitation Services offer specialized treatment for cancer and surgery patients struggling with lymphedema. Such treatment consists of a form of massage called manual lymphatic drainage, or a light rerouting massage. Other components of treatment include compression bandaging, special exercises to increase lymphatic drainage and skin care and precautionary advice, according to Tammy Parker.
“Our treatment strives to decrease swelling in the affected limb, decrease pain, improve range of motion and strength, improve function in everyday activities and self-care and overall self-esteem and well-being,” states Parker. “Our final goal of treatment is to provide the patient with the tools and knowledge they need to further manage their condition after discharge from formal therapy services.”
Parker has been an Occupational Therapist for over 25 years and has been certified in Lymphedema since 2001. The LANA certification is a national certification designed to standardize a high quality of care. To become certified one must complete a certified course of 135 hours, complete a year of clinical experience in the field, and then sit for a national exam. Recertification is required every 6 years with certain educational requirements completed to ensure therapists continue to maintain their education and highest skill level.
“We are proud to offer this program to our community. We always ensure that we are able to provide the best level of care to our patients and just wanted to emphasize the high level of expertise that our staff maintains,” states Tammy.
Patients interested in this CRMC program first require a prescription from their doctor. From there, they are encouraged to contact the Occupational Therapy Department of the hospital at (609)463-2635 to schedule an appointment. For further information contact Tammy Parker, OTR/L, CLT-LANA.
Shore Memorial Hospital of Somers Point has also been a major support resource for local breast cancer patients struggling with this condition. The hospital provides therapy for patients with Lymphedema on an outpatient basis. There, specially trained physical therapists employ the traditional components of the Vodder Method of complete decongestive therapy (CDT) to improve lymphatic flow and eliminate excess fluid.
This treatment regimen typically spans five days a week for a four week period, but can be tailored to meet individual needs. Please call 609-653-3512 to schedule an appointment or to join the mailing list.
Shore Memorial also sponsors a bi-monthly Lymphedema support group that welcomes anyone and everyone. Please call 609-653-3512 to schedule an appointment or to join the mailing list.