Living with Lymphedema

WakeMed Outpatient Rehabilitation therapists are certified and qualified to deliver complete decongestive therapy (CDT). They are trained in the Dr. Vodder method of manual lymphatic drainage — the gold standard for people living with lymphedema.

The Lymphatic System Explained

The lymphatic system is a complex network of lymph vessels and nodes throughout the body that travel the same route as blood vessels. The lymphatic system connects to the circulatory system and is responsible for the body’s ability to fight infections. Lymphedema occurs when there is an accumulation of excess fluid in various parts of the body due to a draingage failure in the lymphatic system.

It may occur in your arms, legs, breast, chest, face, head, neck, trunk or genitals.

Lymphedema Causes

There are many reasons a person may develop lymphedema.

Various cancer treatments may result in lymphedema, yet not everyone will develop lymphedema as a result of cancer treatment.

Venous insufficiency is a dysfunction in the vascular system that may put increased demand on the system, triggering lymphedema.

Lipedema is a condition that may lead to lymphedema or lipo-lymphedema. Hallmarks of lipedema are hypersensitivity or tenderness in the arms and/or legs, easy bruising and spider veins.

Trauma to the lymphatic system can result from surgeries or accidents that damage superficial and/or deep parts of the lymphatic system.

Congenital (also known as primary) lymphedema is when it occurs at birth. Some people are born with differences in their lymphatic system that may require the lymphatic system to work harder, resulting in lymphedema.

Patients living with lymphedema may need the help of a professional for long-term strategic management. A certified lymphedema therapist (CLT) can provide guidance and an action plan to decrease risks for lymphedema following cancer treatments. A CLT can additionally provide early intervention for chronic venous insufficiency. They are also able to treat both lipedema and lipo-lymphedema as well as address lymphedema resulting from trauma or congenital defects.

Lymphedema Evaluation

A formal therapy evaluation, which may involve SOZO Bioimpedence Technology, is requried before treatment. SOZO is used to assess only early stages of lymphedema and may not be appropriate for all.

WakeMed was the first hospital system in North Carolina to include advanced technology for early detection of lymphedema using the SOZO bioimpedance spectoscopy. WakeMed’s therapists utilize the SOZO screening tool for those who are at risk for developing lymphedema. Research has proven early detection will yield positive treatment results for patients, leading to a higher quality of life for patients and their families.

WakeMed is currently the only hospital in the Triangle to include an advanced SOZO® screening as part of the evaluation.

SOZO can rapidly detect certain changes in the body before any symptoms occur, which can reduce the incidence of clinical lymphedema by almost 90 percent. This technology actually makes lymphedema prevention possible for some patients, and it can monitor the efficacy of treatment is patients who have already been diagnosed with it.

Lymphedema Treatment

Many methods are available to manage lymphedema. A CLT will evaluate and work with patients to establish a customized treatment plan, providing tools to manage lymphedema over time.

There are two stages in the treatment of lymphedema, and how this is initiated varies by patient as all plans are individualized. Here is a very general overview of what patients may generally experience:

Intensive Phase

Complete Decongestive Therapy (CDT) is begun.

1 – Skin inspection/care

• Improving skin integrity identifying superficial openings/cracks and promote good hygiene to decrease risk of infections.

2 – Manual Lymphatic Drainage (MLD) techniques

• A skin-stretching technique is used to clear the lymphatic system of stagnant lymph fluid.
• Then, fluid stuck in the tissues is directed to new lymph pathways to encourage efficient flow and reduce swelling.

3 – Multilayer Compression Wrapping

• Several layers consisting of soft padding and short-stretch bandages are used to get a proper compression gradient that will counteract venous pressure, increase pressure on tissues, provide support to skin to allow active muscles to encourage movement of lymphatic fluid through veins and lymph vessels.

4 – Exercises in Compression

• With compression, specific exercises are taught that activate muscles and encourage skin to stretch under compression wraps.
• This also helps veins and lymph vessels effectively pump fluid back into the body.

Maintenance Phase

1. Patients and their caregivers are trained throughout the intensive phase on how to self-manage this chronic condition throughout their lifetime.
2. Proper daytime and nighttime compression garments (or devices) are obtained by the patient. In some cases, a lymphedema pump is also needed.
3. Patients continue to manage lymphedema on their own to prevent complications of this progressive condition.

Expertise Available at WakeMed

Our therapists work as a team to provide comprehensive, timely and consistent care. Please contact one of the following WakeMed Outpatient Rehabilitation locations where lymphedema evaluation and treatment are available.

WakeMed OP Rehab – Clayton

104 Medspring Drive Suite 210


Clayton

WakeMed OP Rehab – Cary

HealthPark at Kildaire


110 Kildaire Park Drive


Cary

WakeMed OP Rehab – Durant

10880 Durant Road Suite 302


Raleigh

WakeMed OP Rehab – Raleigh Medical Park

23 Sunnybrook Road


Raleigh

OT/Lymphedema Referrals:

For lymphedema referrals, medical staff may fax an order to 919-238-1354.

Patients may call 919-350-7000 to schedule an evaluation.

Learn more about our Breast Cancer Rehab & Wellness program at WakeMed.