Lymphoedema is a swelling that occurs when lymph collects in a limb or other part of the body.
Lymph is a clear, colourless fluid that accumulates in the spaces between body cells and is collected by the vessels of the lymphatic system. It flows through the lymphatic vessels to the lymph nodes and is eventually absorbed into the bloodstream. The lymphatic system plays an important role in the immune system by filtering excess fluid, bacteria and byproducts of infections in the lymph nodes.
Normal lymph drainage is sometimes interrupted or hampered as a result of damage to the lymphatic vessels and lymph nodes. This causes lymph to accumulate in the affected limb or park of the body.
Damage to the lymphatic vessels and lymph nodes can be caused by the tumour or by infection, but in most cases it is caused by the treatment. Lymph nodes can be damaged or removed during breast surgery and radiotherapy in the armpit area may cause lesions.
Many surgeons help to reduce the risk of lymphoedema by avoiding the routine removal of lymph nodes during surgery and rather opting for sentinel node biopsy.
It can occur weeks, months or years after surgery.
Acute, moderate lymphoedema may occur immediately after surgery and is usually temporary. Acute and painful lymphoedema can present 4 to 6 weeks after surgery. The most common type of lymhoedema start gradually and is relatively painless. It usually occurs 18 to 24 months after surgery or radiotherapy.
There are no specific diagnostic tests for lymphoedema. The doctor will make a diagnois based on your medical history and by examining you.
Circulation in the lymphatic system is hampered – as a result infection is not combated effectively. That is why it is very important to promote circulation as much as possible and to prevent possible infection.
The onset of lymphoedema is usually caused by a specific trigger, such as injury to the arm or hand nearest the damaged lymph node, for example a bruise, cut or preassure (by a blood pressure cuff, bracelet or elastic cuff). After surgery to an area where lymph nodes may have been damaged, such as the breast or armpit area, it is of the utmost importance to avoid these triggers and to do post-surgery exercises to promote drainage.
Check any swelling, a feeling of heaviness or tightness or a constant pain or discomfort in or against the arm on the operated side. Your hand may swell – take not if your rings become too tight. The affected arm may also feel weak. You must inform your doctor of even the smallest sign of swelling.

Treatment

Your doctor will assess the condition by comparing the swelling with the other arm and determining whether any tightness or heaviness is present. Any other possible causes, such as infection, a tumour or thrombosis will be ruled out. Treatment for lymphoedema usually includes wearing a compression bandage. Lymphatic manual draining (a medical massage technique) may also be prescribed. Exercise and certain preventative measures are also recommended.
It is an elastic bandage in the shape of a garment, such as a sleeve that fits tightly around the arm. A compression sleeve may cover the whole arm, as well as the writs and shoulder. It made by qualified staff according to the doctor’s prescription and must be replaced every 4 to 6 months to ensure a tight fit. The compression bandage exerts pressure on the swollen arm and prevents lymph from accumulating in one area. It is worn according to the doctor’s instructions, sometimes only during the day, sometimes 24 hours per day. By wearing the compression bandage regularly lymphoedema can be improved considerably.
Exercise improves the flexibility of your arm and promotes the drainage of lymph. Your doctor or physiotherapist can prescribe appropriate exercises. The Reach for Recovery exercise pamphlet is specially compiled to improve lymphoedema.
Lymph drainage by means of gentle manual massage is a medical message technique which can reduce swelling and pressure. It is particularly effective if lymphoedema is diagnosed early.