April 4, 2014

Lymphedema is a condition that causes swelling because of fluid buildup in soft body tissue. It is typically seen in an arm or leg, but isn't exclusive to those areas.

Lymphedema is common after cancer treatment, but can occur anytime lymph (a clear fluid that fights infections in the body) is restricted from flowing properly throughout the body.

Blair Johe, PT, CLT, LANA® certified, is the lymphedema therapist at the CAMC Physical Therapy Center. Johe is the only certified lymphedema therapist in Charleston, and sees patients of a wide age range and with a variety of therapy needs.

According to Johe, there are two classifications of lyphedema. Primary lymphedema develops because of abnormal development of the lymph system. Secondary lymphedema is caused by damage to the lymph system, which can be caused by infection, injury, cancer, radiation, etc.

Symptoms of lymphedema include swelling (usually of the arm or leg), tightness or thickening of the skin and trouble moving a joint in the affected area.

There is currently no cure for lymphedema, but there are many techniques to help patients manage the condition and continue to perform daily activities as normal.At the CAMC Physical Therapy Center, Johe
practices complete decongestive therapy.

This includes teaching proper skin care, which can include cleansing and application of creams; manual lymph drainage (a light massage-like therapy performed by Johe); multi-layer bandaging to help prevent
further swelling and fluid buildup; and providing patients with exercises to do at home.

"The hallmark of lymphedema exercises is as much relaxation as movement," Johe said.

Johe typically sees a patient daily for two or three weeks to get the swelling down to a manageable point. Around the ninth appointment, Johe measures the patient for a custom garment, like a sleeve or stocking depending on the location of the lymphedema. When the patient is released from therapy, he or she will continue to wear the garment indefinitely to keep the condition in check.

"Even just one or two days of not wearing the garment can put us back to where we started," Johe said. "That's why education is such an important component of the therapy—you have to understand how the
lymphatic system works."

Patients living with lymphedema should avoid any major temperature changes, like sitting in a hot tub, and should make every effort to avoid sunburns, as it will further damage the lymph system. Patients
should exercise regularly, but not over exert themselves, since muscle soreness and muscle damage can exacerbate the lymphedema.

For more information on lymphedema and how the lymphatic system works, visit ouronline Health Information Center at http://healthinfo.camc.org.

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