FREQUENTLY ASKED QUESTIONS
ABOUT LYMPHEDEMA

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Lymphedema is an accumulation of lymph fluid between the tissue layers. This presents as swelling or edema. Lymphedema can be present anywhere in the body. Areas affected by lymphedema may be very thick and heavy feeling. Treatment is necessary to move the fluid and excess protein out of the area. If you don’t receive proper treatment, over time, the lymphatic vessels will stretch out permanently and you may need external compression and treatment for the rest of your life to maintain proper pressure in the valves to move fluid more normally. Not only that, lymphedema also causes oxygen levels in the vessels to drop, keeping wounds, surgery sites, and skin ulcerations from healing. That can put you at risk of cellulitis, or infections of the bloodstream.
Complete Decongestive Therapy (CDT) is the current international standard and therapy of choice for treating Lymphedema, endorsed by the American Cancer Society and the National Cancer Institute. Components of CDT include short stretch compression bandaging, skin and nail care, decongestive exercises, and Manual Lymphatic Draining (MLD).
Manual Lymphatic Drainage (MLD) re-routes stagnant lymphatic fluid by stimulating healthy and more centrally located vessels and nodes that ultimately drain into the venous system. MLS has been studied to be most effective when used in conjunction with three other components of complete decongestive therapy. A combination of all four interventions is the optimal treatment for reducing girth and maintaining the size and shape of the limb for a longer period of time.
Although MLD is most commonly used to treat Lymphedema, it is also greatly beneficial in the healing of wounds and venous insufficiency, when vein walls are weakened and valves are damaged. This causes the veins to stay filled with blood, especially when you are standing. Several studies have shown there are orthopedic diagnoses and post traumatic injuries that cause edema which could also benefit from MLD techniques. MLD has been shown to reduce pain and stiffness for patients with fibromyalgia and inflammatory rheumatoid arthritis. MLD can help decrease limb volume and pain and can help increase range of motion and functional pain-free extremity use.

Physical Therapy Lymphatic & Wellness Center offers services that reduce edema, facilitate lymphatic float and can thereby improve the healing time for chronic wounds. Physical Therapy Lymphatic & Wellness Center does not provide wound care specifically. We do provide lymphatic therapy as an adjunct treatment for wound care in combination with other health care providers.

There is a new FDA-cleared, technology called low frequency impedance which allows a medical provider to clinically assess and treat the onset of lymphedema earlier and to clinically monitor therapy more closely. Studies have shown that the use of low frequency impedance is able to assist health care providers in clinically assessing a patient and diagnosing lymphedema as much as 4-10 months earlier than other methods.
We are confident that ALL of our therapists are skilled and certified in CDT/MLD treatment and will provide you with the highest quality of care each visit you are here.
Whether it is your arm or your legs that are bandaged, it is up to your discretion if you feel comfortable and safe to drive while being bandaged. Make sure to wear shoes that fit you and are secured well.
Of course you can still take a shower while you are coming for therapy and being bandaged, however, you will need to keep the bandages dry. We have a device available for purchase called an Aquashield (cast protector) which will cover your bandages well and keep you dry while you shower.

Most patients have NO pain while going through our therapy. The MLD therapy is a very light touch and a very relaxing massage. The bandaging does NOT hurt, however, when they are first applied they will and should feel snug. After doing the required exercises the bandages stretch out and you will be more comfortable. Therefore, it is crucial that you do your exercises daily, especially right after you have been bandaged. Also, it is crucial that you drink plenty of water and limit your sodium intake to 2000 mgs per day.

We are confident that with the education you receive here, you will be well informed about your swelling condition. We do not CURE you, but we do get your swelling down and teach you what you need to do for yourself at home to keep the swelling under control. With proper education and maintenance, you will keep the swelling down long term and be healthier in the long run. Many patients choose to come in for a monthly maintenance treatment.
MLD is very different from regular massage because it is a very light skin touch technique. MLD is a very slow, light and rhythmic stretching of the skin in circular movements with a stretching and relaxation phase.
Depending on the severity of the Lymphedema condition, some patients do come daily. Once the patient progresses, treatment is reduced to three times a week until goals are met. Every patient’s situation varies.

MLD does not interfere with any other therapies. Be sure to check with your insurance company to make sure they will cover more than one therapy at a time. We cannot simultaneously treat a patient receiving home health care through Medicare.

You will be able to apply your garments independently. Your therapist will provide you with the proper techniques and devices to help you apply your garments.