Lymphedema is a build-up of lymph fluid in body tissue or just under the skin. This build-up causes swelling (or edema); most often in the arms or legs, but in rare cases it can also affect the face, neck, abdomen or genitals. Lymphedema is a common disorder, affecting an estimated three million Americans.

There are two types of lymphedema: 

• Primary lymphedema occurs in people born with genes that put them at an increased risk of developing lymphedema. This lymphedema is caused by lymph nodes or vessels that are missing or not working the way they should. This type of lymphedema is rare and may appear at any age.
• Secondary (or acquired) lymphedema, the most common form of the disorder, can be a result of surgery, radiation, trauma, infection, malignant tumors, or anything that changes or damages the normal, healthy lymph system. It can also appear at any age.

The symptoms of lymphedema vary among individuals and in severity. Affected areas of the body may display the following: 

• Swelling 
• Sensation of fullness or heaviness 
• Tightness and stretching of the skin
• Reduced movement of the joints
• Skin discoloration
• Thickening and dryness of the skin
• Discomfort 
• Lowered immunity in affected areas

There is no cure for lymphedema; however, treatment can help manage the symptoms.

The lymphedema therapists at UHS have clinical training in Complete Decongestive Therapy (CDT), a gentle, non-invasive treatment that has proven effective for patients with mild to severe primary or secondary lymphedema. At UHS Wilson Medical Center, we deliver this treatment to patients on an outpatient basis, while UHS Home Care provides CDT to patient in their home.

CDT includes four components:

1. Manual lymph drainage: a gentle manual technique that reroutes excess lymph fluid into areas of the body where the lymph system is functioning properly    
2. Compression therapy: after each manual lymph drainage session, multilayered bandages are used to wrap the affected limb to prevent re-accumulation of fluid; compression garments are used in later phases of treatment 
3. Decongestive exercises: with bandages (or compression garments) in place, patients exercise at a light to moderate level; exercises help reduce swelling
4. Skin and nail care: to reduce the chance of bacterial and fungal growth, patients are instructed in proper cleansing, moisturizing and self-inspection of the skin 

CDT is delivered in two phases:

1. The intensive or decongestive phase, during which the patient is seen on a daily basis and treatments are provided until the affected body part is decongested. The duration of this phase varies with the severity of the condition, but averages 2–3 weeks for patients with upper extremity lymphedema and 2–4 weeks for patients with lymphedema of the leg. In extreme cases, this phase may last 6–8 weeks and may have to be repeated several times.
2. The self-management phase occurs once measurements of the affected extremity approach a plateau. During this phase, the patient assumes responsibility for managing, improving and maintaining the results achieved.

Most insurance plans and Medicare cover CDT, but a physician referral to the program is needed. This referral may come from your primary care provider, oncologist or other physician. 

Location 

For more information about our lymphedema treatment programs, please contact:

• For outpatient services: UHS Physical Therapy and Rehabilitation Johnson City, UHS Wilson Medical Center, 607.763.6033
• For home health care services: UHS Home Care, 607.763.8946 or 800.295.2212

• UHS offers a free, monthly lymphedema support group. Led by a trained lymphedema therapist, the group meets the second Thursday of each month from 5:30 to 6:30 p.m. at the Stay Healthy Center at Oakdale Mall in Johnson City (near Sears). To register, please call 607.763.5092.