Frequently Asked Questions (FAQ)
Lymphedema Therapy
Q.
What is Lymphedema
A.
Lymphedema is chronic swelling of an area due to permanent obstructions of the lymphatic pathways that carry fluid, which contains proteins and waste products, from tissues throughout the body. While some cases are congenital (primary lymphedema) most cases are caused by removal of the lymph nodes after surgery or damage from radiation treatments (secondary lymphedema). Secondary lymphedema can develop immediately post-operatively or weeks, months or even years later. It can be triggered by trauma to the lymphatic system, air travel (due to sudden change is cabin pressure), sunburn, bug bites or skin infections.
Q.
Why would I need Lymphedema Treatment?
A.
Lymphedema therapy may be necessary if you experience swelling, discomfort, or limited mobility in your limbs due to lymphatic system issues. This condition can arise from various factors, including surgery, radiation therapy, injury, or genetic predisposition, which disrupt the normal flow of lymph fluid. Lymphedema therapy helps manage these symptoms and promotes better circulation, reducing swelling, improving range of motion, and enhancing overall quality of life.
Q.
Can Lymphedema be cured?
A.
Lymphedema cannot be cured, but it can be managed. Exercise, proper skin care, frequent massage and wearing compression garments can help you maintain and manage lymphedema independently.
Q.
What are some commonly used terms for Lymphedema?
A.
Complete Decongestive Therapy (CDT), also called Complex Decongestive Therapy, is considered the “gold standard” for lymphedema treatment. CDT consists of four foundations: Manual Lymphatic Drainage (MLD); Compression; Exercise and Skin Care.
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Manual Lymphatic Drainage (MLD): Through this lymphatic massage, lymph fluid is moved through a gentle massage technique from the congested area into an unaffected area. It is then filtered through the bloodstream and removed through the kidneys.
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Compression: Compression bandaging is an application of several layers of short-stretch bandages (not the ones used for a sprain) over the involved limb to reduce fluid. Compression garments are worn daily to maintain the reduction of fluid.
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Skin Care: Good skin care and hygiene are essential to treating lymphedema and preventing cellulitis. Because the skin is often dry and cracking, a good lotion should be used to improve its texture. Skin integrity is also a concern, so proper cleaning and wound care are important.
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Cording: Also known as Axillary Web Syndrome. Sometimes develops as a side effect of lymph node dissection, cording tends to be painful and restrict range of motion. Researchers are not sure what cording is made of, but it seems to form after trauma, such as surgery. Inflammation leads to scarring and hardening of the tissue encasing blood and lymph vessels. This creates the cords which can spread down the arm.
Fibrosis: The formation of fibrous (hard) tissue caused by the repair process, as in scar tissue. Fibrosis can occur after surgery and radiation treatment, or tissue can become fibrotic when lymph fluid is stagnant in one area for too long.
Q.
Should I rest my affected limb?
A.
The latest research shows that exercise is a huge part of lymphedema management and prevention. The muscles serve as a pump to move static fluid from the limbs into the blood stream. Cardiovascular exercises increase circulation and assist in this pumping action. The old though of "babying the limb" is outdated and can actually worsen edema.
Q.
How many sessions will I need to come to Lymphedema therapy?
A.
Initially, your therapist may want to see you two or more times per week, until the reduction stabilizes. Since lymphedema is a lifelong condition, your therapist will teach you self-massage, exercise and bandaging so you may manage your lymphedema at home. You may need to come in for occasional MLD as needed, if you experience a flare-up of swelling.
Q.
Is Lymphedema treatment covered by insurance?
A.
Coverage for Lymphedema treatment varies depending on insurance plans and policies. Many insurance providers offer coverage for physical therapy services, including Lymphedema therapy, but specific benefits, deductibles, co-payments, and limitations may apply. It's advisable to contact your insurance provider to verify coverage details, including any preauthorization requirements or out-of-pocket expenses. Wellness 360 does offer cash-pay options or payment plans for individuals without insurance coverage. Give us a call if you have any questions regarding your insurance (585-482-5060). Our providers can assist you in navigating insurance inquiries and exploring alternative payment options to ensure access to necessary care while maximizing insurance benefits.
Q.
Are there strategies I can do at home to complement my lymphedema treatment?
A.
Yes, your therapist will teach you self-massage, exercise, and bandaging to manage your lymphedema at home.
Q.
How long do I have to wear my bandage?
A.
In the typical treatment of lymphedema, a patient begins by bandaging 23/24 hours a day, and once the volume of a limb stops decreasing, the patient is then prescribed a garment. Garments are worn daily to maintain the reduction in swelling, but they do not reduce the volume. For this reason, the patient continues to bandage at night, or will wear a special nighttime compression garment.