In understanding lymphedema it is important to know that there is no current cure for this condition. At the very best with early diagnosis and proper treatment the condition can be maintained and controlled. Even those whose condition is considered extreme because of lack of early diagnosis can only ever hope to maintain their lymphedema while avoiding infections. However, as with all life altering conditions there ways and methods that can greatly help those with lymphedema.
What is the Lymph System
The lymphatic system tends to be an often overlooked part of the circulatory system. It is comprised of a vast network of conduits known as lymphatic vessels that carry a clear, thick protein filled fluid called lymph which flows unidirectionally towards the heart. Lymph is what remains as blood passes through the capillaries of the body, and diffusing into the surrounding tissues. A properly functioning lymphatic system collects and recycles this fluid, which flows through lymph nodes along its course towards the heart.
Cells of the lymph nodes phagocytize, or ingest, impurities such as bacteria, old red blood cells, and toxic and cellular waste. Finally, lymph flows into the thoracic duct, a large vessel that runs parallel to the spinal column, or into the right lymphatic duct, both of which transport the lymph back into veins of the shoulder areas where is mixes with blood and is returned to the heart. All lymph vessels contain one-way valves, like the veins, to prevent backflow. On a daily basis 90% of the blood plasma that passes through the tissues of the body gets reabsorbed directly into the blood vessels. The lymph system provides an accessory route for the remaining 10% of excess plasma, or lymph, to get returned to the blood. Lymph is essentially recycled blood plasma. The lymph is moved along the lymphatic vessel network by either intrinsic contractions of the lymphatic passages or by extrinsic compression of the lymphatic vessels via external tissue forces.
Types of Lymphedema
Lymphedema most commonly occurs when the lymph system has been comprised either genetically or through a traumatic injury. Lymphedema comes in two forms: Primary Lymphedema and Secondary Lymphedema. Primary lynmphedema (PLE) is often associated with it being inherited and is caused by a defect of the formation of the lymph system before birth (congenital), but it can develop at the onset of puberty (praecox) or in adulthood (tarda), all from unknown causes. Secondary lymphedema (SLE) is often the result of damage being done to the lymphatic system after birth. Most frequently this is caused by cancer, cancer treatment, or radiation. SLE can also be caused from injures, other types of surgeries, burns and the crushing of the lymphatic system from weight.
Stages of Lymphedema
The stage of lymphedema is determined as part of the diagnosis. Lymphedema can be successfully treated in all stages, but the best and most rapid results occur when the lymphedema is identified and treated early.
Stage 0: There are no visible changes to the limb or area at this point, but you may notice a difference in feeling, such as a mild tingling, unusual tiredness, or slight heaviness. You can have stage 0 lymphedema for months or years before obvious symptoms develop.
Stage 1: The limb or other area appears mildly swollen as the protein-rich fluid starts to accumulate. When you press the skin, a temporary small dent (or pit) forms; you may see this referred to as “pitting edema.” Such early-stage lymphedema is considered reversible with treatment because the skin and tissues haven’t been permanently damaged. When you elevate the arm, for example, the swelling resolves.
Stage 2: The affected area is even more swollen. Elevating the arm or other area doesn’t help, and pressing on the skin does not leave a pit (non-pitting edema). Some changes to the tissue under the skin are happening, such as inflammation, hardening, or thickening. Stage 2 lymphedema can be managed with treatment, but any tissue damage can’t be reversed.
Stage 3: This is the most advanced stage, the affected limb or area of the body becomes very large and misshapen, and the skin takes on a leathery, wrinkled appearance.