Description of lymphedema
Lymphedema is a protracted illness with swelling. Arises as a result of a malfunction of the lymphatic (or lymphatic) system, in which there is a build up of fluid (lymph, lymph) in the tissues.
Lymphatic system
Everyone knows that our body circulating blood. That they (oxygenated) leads towards the tissue (eg, a finger), one type of blood vessels (arteries), which become thicker and they are completely thinnest, join them the second type of blood vessels(veins) and the resulting blood back through the heart into lung .. the point of mutual connection of the walls of the blood vessels so thin that, through them, fluid may flow .. due to the overpressure in the vessel (hydrostatic gradient) before the concentration of leaking vessels. Conversely, after the connection throughoncotic gradient (in a blood vessel is more protein, fluid from the environment tend to dilute protein in the vessel) the fluid is sucked into the vessel. The tissue thus occurs pouring and collecting fluids .. These two happening are not in balance .. Around 10% of the fluid in the space around the joint vessels (ie tissue) remains.
And just about the removal of the rest of the old system, about which many people know, namely the lymphatic system. His blood vessels begin blindly in tissues where fluid (lymph) suck. They align in the lymph nodes and leading to the heart. Ahead lymph pouring into the veins of the applied blood.
The principle of lymphedema is therefore one that is not working properly discharge generated an excess of fluid in the tissue of the lymphatic system, lymph fluid accumulates in the tissue and the site swells.
We distinguish between primary and secondary lymphedema:
primary lymphedema
Primary lymphedema is a congenital disease (hereditary and non-hereditary distinguish form).Usually develops during puberty (but may occur later speech – for the 35th year).
Impaired function of the lymphatic system is the primary lymphedema caused by badly developed lymphatic system. May be triggered trauma, infection, excessive stress, prolonged sitting or standing .. often manifests itself spontaneously.
Swelling occurs in the extremities, especially in the feet – at the periphery (area toes, ankles ..).Sometimes swelling asymmetric, ie on the second leg is completely missing (hence the alternative name elephant foot). Dissemination of primary lymphedema occurs proximal (ie. The center of the body – the leg toward the hip, hand to shoulder) – referred to as the ascending form.
secondary lymphedema
Secondary lymphedema can occur at any age as a result of injury to the lymphatic system. The perpetrator of the injuries are the most common tumors (their penetration into lymph vessels, lymph node metastasis), injuries, transactions in which the nodes are removed (usually by surgery tumors) .. high risk of developing secondary lymphedema is with paralyzed limbs.
Secondary lymphedema occurs in the descending form, because the maximum swelling occurs just below the obstacle preventing the outflow of lymph, and spreads distally (to the edges of the extremities – fingers).
Risk factors for lymphedema
The primary risk factor for lymphedema is heredity.
For secondary lymphedema is a risk factor for tumor radiation therapy (both of which can damage the lymphatic system). Another major risk is the operation of extracting lymph nodes (a typical problem for women after breast cancer surgery, the act of removing underarm lymph nodes – these patients may have difficulty with lymphatic drainage of the arm)
prevent lymphedema
Prevention applies only to secondary lymphedema. And especially in the above mentioned operations tumors (excluding the adjacent nodes due to the risk that it would have to be alluvial tumor cells – removal of lymph nodes, however, impairs functioning of the lymphatic system, therefore, the emphasis after these operations to prevent lymphedema using appropriate massageand exercise )
Symptoms of lymphedema, as manifested lymphedema
Lymphedema can occur in all places, where are the lymph, and can therefore lead to a breach of its removal. The most common site but are limbs.
The first sign of lymphedema is not swollen, but the pressure, vague pain, sometimes fatigue,deterioration of the function of the limb.
Infrequent, but the success of treatment is very beneficial in the detection of the disease (ie. The latent) phase. The correct diagnosis should help physicians information about past or current cancers patient for surgery with removal of lymph nodes ..
Lymphedema is more commonly diagnosed in the next stage, when it is present swelling (pale,cold, painless, occurring usually in the evening, disappearing into the morning ..). At this stage, the success of treating lymphedema lower.
Often, based on finding the causes of lymphedema occurs in the patient a tumor which can be previously and successfully treated. So this is the only advantage of lymphedema.
The third stage of lymphedema manifests stiff, pale swelling, which already restricts patientmobility in the affected area. Swelling at the site of skin is thickened.
The hardest stage of lymphedema is known as elephantiasis (affected limb lymphedema is also called elephant foot). The skin is stiff in this stage (resulting fibrotisation subcutaneous), joint mobility in the affected area is completely limited.
treatment of lymphedema
The treatment of lymphedema is complex and does not lead to an overall recovery of the patient. However, it retards enlarging swelling and the associated negative physical and psychological feelings of the patient.
Treatment consists in regime measures. These include monitoring of patient weight, hygiene (skin care and nails), beauty care (skin promašťování), wearing loose clothes, avoiding prolonged sitting or standing. It is advisable to at least minimally operate any sport (movement is important for the “kick-” drain the sap), avoid high temperatures (in that heat lymphoedema getting worse by the fact that most of the lymphedema manifests just in summer), avoiding infections (of them is very dangerous erysipelas – rose) .. Any irritation or skin injury is also not desirable.
Another part of the treatment are massages, lymphatic drainage and compression therapy.
Massage – is carried out very gently, but rather a sort of petting stimulating activity lymphatics (lymph However shifted peripherally – to edge – with an effort to find an alternative route to the heart)
Instrumental lymphatic drainage – a patient to the affected area seeded sleeve with many chambers, which gradually toward the center of the body filled with air. These pressure waves move lymph. However, there is risk of lymph accumulation shifted only in a place other than hitherto (for drainage of the hand it can be an arm, a leg genital area). Therefore, the drainage rack used in combination with hand massage that most lymph drained alternate path.
After lymph drainage is always necessary to attach a compression bandage (elastic girdles, stockings ..), which causes less blood flow to the area, thus creating a smaller amount of lymph
How can I help myself
Compliance with the amended scheme, motion, frequently performing a thorough massage with subsequent compression (see treatment)
complications of lymphedema
The most common complication is infection with lymphedema. Frequent are fungal diseases, bacterial infections should be mentioned erysipelas (rose) and the viruses can attack lymphedema affected area (warts).
Another unpleasant complications, which also increases the risk of infection are the fistula.
Other names: lymph edema, elephant foot, a failure of the lymphatic system, lymphatic system failure, primary lymphedema, secondary lymphedema
