Lymphoedema

What is Lymphoedema? Lymphoedema is a chronic condition which causes swelling to any part of the body but is most common in the arms and legs. This condition develops when the lymphatic system, which drains fluid from the tissues of the body, does not function normally due to either a congenital abnormality or under development (Primary Lymphoedema), deficiency or damage to the lymphatic system (Secondary Lymphoedema) which can be due to cancer, surgery, radiotherapy, trauma, disease, infection, obesity etc. Lymphoedema cannot be cured but it can be treated and well managed, particularly if diagnosed early.

What to expect from our service Our Lymphoedema Team consists of nurse therapists, physiotherapists, lymphoedema therapists and administrative support. Your first contact with our service will be a call from one of our team to book an assessment visit. During this appointment we will ask questions about your health and your lymphoedema and how it may be affecting you at this time. We will also examine and measure the affected area and check your weight. This will give you the opportunity to ask questions and to gain a greater understanding about the management of the condition and how we can work together to achieve a good result. By attending for treatment and following your therapist’s advice, our aim is to start to control your lymphoedema rather than it controlling you.

Manual Lymphatic Drainage and Intermittent Pneumatic Compression Manual Lymphatic Drainage (MLD) is a specialised therapy designed to improve the function of the lymphatic system. This is achieved through gentle movements to the skin which help draw lymph fluid into the lymph vessels below the skin. MLD results in a greater amount of waste products and excess fluid being removed from the body’s tissues into the lymphatic system. This effect can also be achieved by use of Intermittent Pneumatic Compression (IPC) where a pump is used to simulate MLD. Your therapist will assess which is the most appropriate for you. Simple Lymphatic Drainage You will be taught Simple Lymphatic Drainage (SLD) which is a simple form of MLD for you to use regularly at home to manage your lymphoedema.

Compression Garments/Bandaging - For many people the use of compression garments for the affected limb or area can contribute greatly to the long term management of lymphoedema. One of our team will carefully measure you for the appropriate garment. This should be comfortable however if you experience any pins and needles or pain, or your fingers or toes change colour, it is too tight. Remove it straight away and contact your lymphoedema therapist for advice. It is important that you are properly measured and fitted to prevent these problems from occurring. The use of compression bandages to improve the shape and size of a swollen limb may be appropriate for a limited number of patients for a short period of time. This will be discussed with you if the team feel that you will benefit. Compression, in whatever form, plays a vital role in the management of your lymphoedema and your compliance is vital.

Lymphoedema Taping -  A special taping technique can be applied to gently lift the top layer of the skin allowing lymph fluid to drain more easily therefore helping to manage pain and swelling. It is often used in areas where it is difficult to apply compression therapy. Skin Care Skin health and skin care is really important, especially for the area affected by lymphoedema. We will advise you on how best to look after your skin and prevent infection, how to recognise an infection and what to do in the event of an infection.

Exercise - Exercise can promote natural drainage of lymph fluid. Advice will be given about what is beneficial and what is not advisable to do regarding exercise. Lifestyle Changes Where indicated you may be advised about diet, weight loss and going to bed at night if this is not your usual pattern. Emotional Support We appreciate that lymphoedema is a difficult condition to live with and will aim to support you through your treatment. Other support services are available at the hospice and can be accessed via your lymphoedema therapist if appropriate

How long is a treatment likely to last? Your assessment visit will take between one and a half to two hours. Any further appointments will take no more than one hour. The use of this time will vary according to the therapist’s assessment and your treatment needs. Treatment can continue over several weeks/months however the frequency of visits will be reduced once your lymphoedema is stable. If you are self-managing, you may be discharged back to the care of your GP, but you will be able to contact the service directly for any help or support after this time if required. Cancellations Due to the large number of patients requiring treatment and the limited availability of clinic appointments we are required to have a strict cancellation policy.

If you cancel more than three times in one year we may discharge you from the service and notification of this will be sent to your GP. Any further treatment will require a new referral from an appropriate healthcare practitioner. In the event of extenuating circumstances this may be reviewed. Please give as much notice as possible when cancelling appointments so that your appointment slot can be offered to someone else.