Q&A with Certified Lymphedema Specialists Courtney Roush and Betty Madison

Betty Madison and Courtney Roush are certified Lymphedema specialists and Physical Therapists at Memorial Medical Center in Ashland.

Betty Madison and Courtney Roush are certified Lymphedema specialists and Physical Therapists at Memorial Medical Center in Ashland.

What is Lymphedema

Lymph is the fluid which is between all the cells of the body, excluding blood.   Lymphedema is chronic swelling in the body due to decreased lymph fluid out of the area caused by blockage.   An abnormal collection of excessive tissue proteins, edema, chronic inflammation and hardening of the tissues occurs.  Stagnant fluid in your tissues will cause immobility, cellulitis (infection of the skin), and usually ulcer formation.  Swelling can be in the trunk,  one arm or leg but can affect both sides.  Lymphedema is long term and there is no cure but can be managed very effectively.

What causes Lymphedema?

The swelling is caused by an interruption in the lymph system, preventing the flow of the body fluid out of an area.  Lymph fluid returns through a series of “ducts”  to the circulatory system and exits the body via the urinary tract.  Unlike the circulatory system it has no autonomic pump.  It relies on an internal vacuum and external stimulation from movement.   It we don’t move, neither does the lymph.  The lymphatic system can be compromised following surgery, trauma, or with obesity, heart disease, kidney disease.  Any scar in the body blocks normal drainage.   A person may be born with a blockage as well.    The natural aging process also damages the network of vessels responsible for picking up the lymph from the tissues.   If a person has any of the other problems mentioned above, the body may not be able to compensate as he/she ages.   Stagnant fluid in your tissues will cause immobility, cellulitis (infection of the skin), and possibly ulcer formation. There is nothing specific that prevents lymphedema although general exercise helps stimulate the lymphatic system to work, and early detection can help manage the swelling.

What are symptoms of Lymphema?

The most common symptom of lymphedema is long term swelling which does not go down at night or with elevation.  Edema may decrease slightly if the person also has a problem with the veinous return, which is typical with lymphedema.   Often times the skin can be shiny and more firm.   The protein in the tissues will cause a brown staining of the skin.   As a result of the swelling, the extremity can feel heavy, stiff and sometimes painful.

I think I have lymphedema. What should I do?

Talk to your physician. Generally lymphedema is diagnosed from history and a physical examination. With an order from your physician,  physical therapist trained in lymphedema management  can provide the necessary treatment to decrease the edema and help you create a plan to help you manage the swelling effectively at home.

 How do you treat it?

A Certified Lymphedema Therapist can perform Complete Decongestive Therapy. This treatment includes general exercise, skin care, light tissue massage, compression bandaging, and a home program. Since lymphedema is a life long condition, management is a very important aspect of treatment. Patients can learn to keep lymphedema under control and usually resume all previous activities.