Swelling of the limbs is not normal: Let's be aware of Lymphedema!

Have you suddenly felt like an arm, leg, or other part of your body has become swollen and heavy? Are the clothes you wear, the rings, and bracelets you wear starting to get tight? This could be a condition called Lymphedema , which we sometimes don't talk about much, but can affect many people. Don't worry. Let's talk about this in a simple and clear way today.

Simply put, what is Lymphedema?

In addition to blood vessels , our body has another system of fine vessels. We call this the lymphatic system . Just like the drainage system in our city, this system collects a liquid (we call it lymph fluid ) that contains waste products, bacteria , and viruses that accumulate in different parts of the body, and filters and cleans them. This filtering process takes place in the lymph nodes in our body.

Imagine, what happens if this drainage system gets blocked or damaged somewhere? Dirty water fills up in one place, and that place stagnates, right? That's what Lymphedema is like. When something is damaged in the lymphatic system, the lymph fluid does not flow properly and accumulates in one place, causing swelling. This most often affects the arms and legs, but it can occur anywhere in the body.

What are the causes of Lymphedema?

Lymphedema is not a single condition, but can be caused by a number of factors. Sometimes it can occur for no apparent reason, or it can be caused by a genetic defect that is present at birth. However, it is most often seen when another medical condition or injury affects the lymphatic system.

Here are some of the main reasons:

• Cancer and cancer treatments : This is the main cause of lymphedema. A tumor can block the lymph vessels. Also, radiation therapy for cancer or surgical removal of lymph nodes to see if the cancer has spread can damage the lymphatic system. Lymphedema is especially likely to occur after treatment for things like breast cancer and cancers of the genital area. Sometimes, this swelling can occur months or even years after treatment.
• Infections:Some bacterial or parasitic infections can damage the lymph vessels and cause swelling.
• Injury: Damage to the lymphatic vessels due to an accident or injury.
• Obesity: As body weight increases, additional pressure is placed on the lymph nodes and vessels, which can impede lymph flow.
• Other medical conditions: Heart disease, kidney disease, and vascular disease can also cause swelling.
• Scars after surgery: The thick scar tissue that forms after surgery can cause the lymph vessels to become constricted.

There are two main types of lymphedema:

Lymphedema can be divided into two main types.

1. Secondary Lymphedema: This is the most common type. Lymphedema occurs when the lymphatic system is damaged by another disease (such as cancer) or treatment (such as surgery).

2. Primary Lymphedema: This is a rare condition. It occurs when the lymph nodes or lymph vessels are not properly developed or are not present at birth. Symptoms can appear during infancy, childhood, adolescence, or even adulthood.

Do you also have these symptoms?

The main and most obvious symptom of lymphedema is swelling. This swelling can affect the arms or legs, sometimes extending down to the fingers. Initially, this swelling may be mild , but over time, the skin may thicken and become hard.

Other symptoms are:

• Feeling like things like clothes, shoes, rings, bracelets, etc. are stuck .
• The skin in the swollen area becomes red, thickened, and feels hard to the touch .
• One arm or leg appears to be larger than the other.
• Feeling pain, heaviness, or numbness in the swollen arm or leg.
• Joint stiffness and difficulty moving .
• Reduced visibility of veins in the arms or legs.
• Frequent skin infections .

Identify the stages of lymphedema

Doctors divide lymphedema into several stages depending on its severity. It's important for you to know this too.

Doctor, how do you accurately diagnose Lymphedema?

Because swelling can be a symptom of many other conditions, your doctor will first take a thorough look at your symptoms and medical history. Then, they may perform some special tests to confirm whether this is lymphedema.

• Lymphoscintigraphy: A very small amount of a radioactive substance is injected and a scanner monitors how it travels through the lymphatic system.
• ICG lymphography: A special dye is injected and it is observed as it travels through the lymphatic system.
• CT scan and MRI scan: These can take three-dimensional images of the inside of the body and detect any blockages in the lymphatic system or other conditions, such as tumors.
• Ultrasound scan: This helps identify blockages in the lymphatic system or blood vessels.

What are the treatments for Lymphedema?

Although lymphedema cannot be completely cured, there are very effective treatments that can control swelling, reduce pain, and help you live a normal life. These treatments will be determined by your doctor based on the severity of your condition.

This often requires the assistance of a physiotherapist who has received special training in the management of Lymphedema.

• Compression garments: These are tight-fitting , sock -like garments that fit tightly around the swollen arm or leg. The pressure they create helps the lymph fluid to move without pooling.
• Specific Bandaging Techniques: Proper bandaging can help push lymph fluid to the upper parts of the body.
• Lymphedema massage: This is not your average massage. This very gentle massage technique (manual lymph drainage) can help move fluid from swollen areas to healthy lymph nodes. You can also learn how to do this technique yourself.
• Exercise: Light exercises, as directed by a physical therapist, help to activate muscles and improve lymph circulation.
• Surgery: Surgery may be considered for severe cases of lymphedema where other treatments have not been successful. This may involve a lymphatic bypass surgery, which creates new pathways to bypass blocked lymph vessels, or a lymph node transplant, which transplants healthy lymph nodes.

Complications that may occur if left untreated

If lymphedema is not treated properly, it can lead to serious complications over time. That's why it's important to tell a doctor about any persistent swelling.

• Cellulitis: This skin infection is one of the most serious complications of lymphedema. Bacteria can easily grow in the accumulated lymph fluid. Because the skin is stretched and thin due to the swelling, infection can easily enter through even a small scratch.
• Sepsis: If cellulitis is not treated quickly, it can spread to the bloodstream and become life-threatening, leading to a serious condition called ``Sepsis.'' This is a medical emergency. In such cases, you should immediately go to a hospital's Emergency Treatment Unit (ETU) .
• Skin changes: Severe lymphedema can cause the skin to become thickened, tight, and change to the point where it is impossible to move.
• Cancer:Very rarely, untreated severe lymphedema can develop into a soft tissue cancer called lymphangiosarcoma.

Things to consider when living with Lymphedema

These tips will help you manage your condition, avoid complications, and live comfortably.

• Protect yourself from injuries: Even a small scratch can lead to infection. So wear gloves when doing yard work and household chores. Use an electric shaver instead of a razor. Avoid insect bites.
• Treat injuries quickly: Even if the wound is small, wash it thoroughly with soap and water, apply an antiseptic cream, and keep it clean.
• Keep the swollen arm/leg elevated: Whenever possible, place a pillow over it and keep it above the level of your heart.
• Maintain a healthy weight: As weight increases, so does swelling. Therefore, it is very important to maintain a healthy weight through a balanced diet and exercise.
• Avoid tight clothing and jewelry: Do not wear tight clothing, shoes, rings, or bracelets on the swollen area. Do not lift heavy bags with the arm that has lymphedema. Do not measure blood pressure with that arm.
• Keep your skin clean and moisturized: Cleanse your skin daily and apply a moisturizer recommended by your doctor.
• Avoid direct sunlight and excessive heat: Heat can increase swelling.

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