lymphedema.

Is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system.


Tissues with lymphedema are at risk of infection.

Lymphedema affects approximately 140 million people worldwide

Lymphedema may be inherited (primary) or caused by injury to the lymphatic vessels (secondary). It is most frequently seen after lymph node dissection, surgery and/or radiation therapy, in which damage to the lymphatic system is caused during the treatment of cancer, most notably breast cancer.

associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly.

The diagnosis or early detection of lymphedema is difficult. The first signs may be subjective observations such as "my arm feels heavy" or "I have difficulty these days getting rings on and off my fingers". These may be symptomatic of early stage of lymphoedema where accumulation of lymph is mild and not detectable by any difference in arm volume or circumference.


Stages

Stage 0 (latent): The lymphatic vessels have sustained some damage which is not yet apparent. Transport capacity is still sufficient for the amount of lymph being removed. Lymphedema is not present.
Stage 1 (spontaneously reversible): Tissue is still at the "non- pitting" stage: when pressed by the fingertips, the tissue bounces back without any indentation. Usually upon waking in the morning, the limb or affected area is normal or almost normal in size.
Stage 2 (spontaneously irreversible): The tissue now has a spongy consistency and is considered "pitting": when pressed by the fingertips, the affected area indents and holds the indentation. Fibrosis found in Stage 2 lymphedema marks the beginning of the hardening of the limbs and increasing size.
Stage 3 (lymphostatic elephantiasis): At this stage, the swelling is irreversible and usually the limb(s) or affected area is very large. The tissue is hard (fibrotic) and unresponsive; some patients consider undergoing reconstructive surgery, called "debulking". This remains controversial, however, since the risks may outweigh the benefits, and the further damage done to the lymphatic system may in fact make the lymphedema worse.


Grades

Lymphedema can also be categorized by its severity (usually referenced to a healthy extremity):[citation needed]
Grade 1 (mild edema): Lymphedema involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 centimeters, and other tissue changes are not yet present.
Grade 2 (moderate edema): Lymphedema involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is more than 4 but less than 6 centimeters. Tissue changes, such as pitting, are apparent. The patient may experience erysipelas.
Grade 3a (severe edema): Lymphedema is present in one limb and its associated trunk quadrant. The difference in circumference is greater than 6 centimeters. Significant skin alterations, such as cornification or keratosis, cysts and/or fistulae, are present. Additionally, the patient may experience repeated attacks of erysipelas.
Grade 3b (massive edema): The same symptoms as grade 3a, except two or more extremities are affected.
Grade 4 (gigantic edema): Also known as elephantiasis, in this stage of lymphedema, the affected extremities are huge due to almost complete blockage of the lymph channels. Elephantiasis may also affect the head and face.


Treatment

Treatment for lymphedema varies depending on the severity of the edema and the degree of fibrosis of the affected limb. Most people with lymphedema follow a daily regimen of treatment as suggested by their physician or certified lymphedema therapist. The most common treatments for lymphedema are a combination of manual compression lymphatic massage, compression garments or bandaging. Complex decongestive physiotherapy is an empiric system of lymphatic massage, skin care, and compressive garments. Although a combination treatment program may be ideal, any of the treatments can be done individually.

Compression
[edit]Garments
Elastic compression garments are worn by persons with lymphedema on the affected limb following complete decongestive therapy to maintain edema reduction. Depending on the therapist's discretion, a compression garment may be custom-fit or purchased in over-the-counter, standard sizes. Compression garments are meant to be worn every day to maintain edema reduction and must be replaced on a regular basis. Support garments may be the only Garment of Choice for patients with Scrotal edema.
[edit]Bandaging or wrapping
Compression bandaging, also called wrapping, is the application of several layers of padding and short-stretch bandages to the involved areas. Short-stretch bandages are preferred over long-stretch bandages (such as those normally used to treat sprains), as the long-stretch bandages cannot produce the proper therapeutic tension necessary to safely reduce lymphedema and may in fact end up producing a tourniquet effect. During activity, whether exercise or daily activities, the short-stretch bandages enhance the pumping action of the lymph vessels by providing increased resistance for them to push against. This encourages lymphatic flow and helps to soften fluid-swollen areas.
[edit]Sequential gradient pump therapy
Compression pump technology utilizes a multi-chambered pneumatic sleeve with overlapping cells to promote movement of lymph fluid. Pump therapy may be used in addition to other treatments such as compression bandaging and manual lymph drainage. In many cases, pump therapy may help soften fibrotic tissue and therefore potentially enable more efficient lymphatic drainage. Sequential pump therapy may also be used as a home treatment method, usually as part of a regimen also involving compression garments or wrapping.
A Stanford University medical study showed that patients receiving the combined modalities of MLD/CDT and pneumatic pumping had a greater overall reduction in limb volume than patients receiving only MLD/CDT.[14] However, some therapists have begun to raise concern that compression pumps can cause genital swelling when used on persons with leg lymphedema.

Surgical treatments for lymphedema
Several effective surgical procedures exist to provide long-term solutions for patients who suffer from lymphedema. Prior to any lymphedema surgery, patients typically have been treated by a physical therapist trained in providing lymphedema treatment for initial conservative treatment of their lymphedema. Complete decompression therapy (CDT), manual lymphatic drainage (MLD) and compression bandaging are all helpful components of conservative lymphedema treatment.

Lymphatic vessel grafting
With the possibilities of advanced microsurgical techniques lymphvessel can be sutured and used as grafts, a technique which is well known in vascular surgery. Locally interrupted or obstructed lymphatic pathway, mostly after resection of lymph nodes, can be reconstructed by a bypass using lymphatic vessels. These vessels are specialized to drain lymph by active pumping forces. These grafts are connected with main lymphatic collectors in front and behind the obstruction. The technique is mostly used in armedemas after treatment of mammary carcinomas and in unilateral edemas of lower extremities after resection of lymphnodes and radiation. The method was developed experimentally at the Institute of Experimental Surgery, the Ludwig Maximilians University (LMU) in Munich. It was introduced as treatment in 1980 by Prof. Ruediger Baumeister[16].
The method is proved to be effective[17]. Follow up studies showed significant reduction of volume of the extremities even 10 years after surgery[18].
The patients, who had been previously treated with both MLD and compression therapy, gained significant improvements in quality of life after being treated with lymphatic vessel grafting[19]. Lymphoscintigraphic investigations at the Clinic of Nuclear Medicine at LMU showed a lasting enhancement of lymphatic transport after grafting[20].
The patency of lymphatic grafts have been demonstrated by the Institute for Clinical Radiology after more than 12 years, using indirect lymphography and MRI lymphography.

OUCHIES....I'VE HURT MY KNEE [act 2]

continuing on from my last post....

So there I was sitting in the eating room for about 2 hrs, sleeping on and off. That's what my body does when i've hurt myself, it uses up the only energy I do have left to help the injured part.

I was finally called into the ER and they asked me to get on the bed so I could be examined. I said "sorry to be rude but there is no way in hell I am getting on that bed, as soon as I lay down and my leg is flat the pain is at it's worse". "Ok" they said "stay in the chair as long as you can" A doctor came in to find out my history (which is literally a medical book in itself) I told him what I had done, told him the medications I am allergic to and he walked off.

Another doctor walked in a while later and asked me to get onto the bed so he could examine my leg. I was hesitant but knew if I was to get an x-ray I had to get onto that bed. I informed this new doctor of what I had done, within 5 minutes an orderly came and took me to x-ray, I bought Steve with me incase they wanted me off the ER bed and onto one of theirs. Lucky for me I got to stay in the bed... thank god.

I had 3 pictures taken of me knee/leg. I had no idea what time it was by then but I was sleeping on and off, they came in gave me some pain killers and explained to me what I had done. Well because I was half asleep what I thought I heard them say was completely wrong and I was informing friends/family of the wrong info. They said I could leave as soon as a physcio therapist came to fit me with a brace. He arrived at 5pm. I have to wear my lovely brace for 4 weeks. As soon as he put it on the pain went away immediately... yay!!

Apparently I have torn my anterior crucial ligament (just like what footballers do). The doctor said that if I was able to walk I may have had to have a knee reconstruction. OMG!! As soon as I heard that I started hating myself, something so trivial, something I do everyday and I have really damaged my knee. I started getting depressed and knew I was unable to look after Hailee, I didn't want her to see me so sad. Luckily my mum was able to watch her for a few days so I could get my head sorted. I knew I needed to get on with things, I knew it would take me twice as long to get out of bed, to get dressed, to be able to do everyday things like laundry (lol). But I had to get on with life.

It's been just over 3 weeks now. I still have pain, again only when I am in bed, so I am on Pan- Forte. I feel as like the top of my leg is hanging on by a thread when I take my brace off during the day, it really isn't the nicest feeling at all!! Actually until the weekend just gone I hand't taken it off since they put it on me in the hospital.

Well that's my big new for this week (LOL) I am hoping to be back to normal in a week or 2. Let's wait and see huh... I shall keep you all updated on how I am feeling.

Night all. I hope you have a wonderful weekend.

Stay safe!
Amanda <3

OUCHIES...I'VE HURT MY KNEE :( [act.1]

It was a normal night in our household we had just finished dinner, Steve was drying Hailee off from her shower when I decided I wanted to get changed into something warmer. It was Wednesday night around 7pm [27th]. I was getting changed on my bed, rolled over on to my stomach and heard the loud POP!! I also felt this sharp pain radiate down my right leg. I instantly knew that I was in trouble. Hubby was in the ensuit and said he heard it too. I sat up in my chair went and watched t.v for the next three hours it never hurt. What? I can't understand why..what's going on (I thought I may have "popped" it back into place when I sat in my chair. BUT as soon as I crawled into bed and lay down I knew everything was WRONG!. I cried on and off. Had some panadol to try get some sleep and tried to convince Steve not to go to work because I needed to go to hospital straight away. Thursday morning I woke u, I couldn't get out of bed so luckily my Mum was here to pick miss Hailee up to take her to daycare(she does every week...thanks Mum). As soon as she left I rang Steve at work and begged him once again to come home. He came home 2 hours later. I was feeling ok in the car, until I got the the hospital when I just wanted to throw up like I had been doing the night before. You can read the rest on Thursday...hehe sorry guys it's late and I'm tired. Night!! Amanda <3