What is the Lymphatic System?

The lymphatic system is part of our immune system; it carries debris of various kinds. Excess proteins, bacteria, waste and toxins are carried to lymph nodes, the material is filtered and is either expelled from the body or re-introduced to the blood stream.

The Lymphatic System consists of tissues and organs. They include the bone marrow, thymus, lymph nodes and spleen, as well as the channels called lymph collectors, ducts and trunks, that carry lymph. There is a series of vessels and glands that comprise the lymph system and they are spread throughout the body similar to blood vessels. Many are found in very superficial tissue, making Manual lymphatic draining an effective way to influence the system. A disruption of the lymph system can eventually undermine its ability to drain fluid properly, resulting in excess fluid in parts of the body, which creates great risks of infection, this condition is called lymphedema and it sets itself aside from other edemas by being high in protein molecules.

There are two main types of lymphedema:

Primary Lymphedema:  The lymphedema is evident at birth or before the age 35, it rare but sometimes manifest later than that. It is caused by hereditary malformation (faulty genes) of the lymph system. This type is rare, affecting approximately 1 in every 10,000 people. It is typically divided into 3 types, Aplasia, hypoplasia and hyperplasia, which speaks to which part and how the lymphatic system is affected.

Secondary Lymphedema: This lymphedema occurs as a result of an outside instigation such as infection, injury, trauma or cancer or cancer treatments, which damages the lymphatic system. Most common cause in the USA is cancer treatment, such as radiotherapy or the removal of lymph nodes and surgery, which may disrupt or damage the lymph system. Other causes are: chronic venous insufficiency, phlebolymphedema, obesity and filariasis.

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Treatment options for lymphedema?

Complex Decongestive Therapy (CDT) is the most common and doctoral recommended treatment for lymphedema. It has four components: 

and two phases. An intensive phase referred to as Phase I and a maintenance/home care phase phase II, both has all 4 components.

MLD (manual lymphatic drainage) –uses special techniques to move fluid into working lymph nodes, where they are then drained. It is crucial that this is done by a fully certified lymphedema therapist (CLT) for patients with lymphedema. The therapist needs a thorough knowledge of the lymphatic system for this to work, mainly because direction and draining locations are crucial not to flood fluid into a compromised region. Manual lymphatic draining can also be done for a non-compromised system with great advantage to immune function and for this you can see a therapist with less extensive training.

MLLB (multilayer lymphedema bandaging) or compression bandaging – when muscles surrounding lymph vessels and nodes contract and release, the fluid moves through the lymphatic system. Unlike the circulation of blood, there is no pump (heart) for lymph fluids. Breathing exercises, muscle movement is what causes valves to open and close and thus move fluid through the different vessels. Bandaging create a barrier with a specific pressure that helps the tissue not expand further, to prevent fluid backlogging and create interstitial pressure that is beneficial for the system to function.

Exercise – light exercises can encourage movement of the lymph fluid out of the limb.  It is important not to overdo it, and follow the directions of your therapist.

Skin Care – is KEY to this condition as waste levels are high under the skin.  Due to movement of the fluid, any small breakage can lead to complications such as cellulitis.  Using low pH-level lotion and soaps is best. Lotions are always applied before bandaging. Meticulous nail care is also key as hang nails can be an easy place for infection.  

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